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Boston - American Association for Thoracic Surgery

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89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTS10:40 a.m. PLENARY SCIENTIFIC SESSIONBallroom A–C, Hynes Convention Center(8 minutes presentation, 12 minutes discussion)Moderators: Thomas L. SprayThoralf M. Sundt, III33. Right Ventricle and Tricuspid Valve Function at Mid-TermFollowing the Fontan Operation <strong>for</strong> Hypoplastic Left HeartSyndrome: Impact of Shunt TypeVictor Bautista-Hernandez, Ravi Thiagarajan, Hugo Loyola, Jared Schiff,Joshua Salvin, John E. Mayer, * Mark Scheurer, Frank A. Pigula, *Francis Fynn-Thompson, Pedro J. del Nido, * Emile A. Bacha *Children’s Hospital <strong>Boston</strong>, Harvard Medical School, <strong>Boston</strong>, MA, USAInvited Discussant: Richard G. OhyeOBJECTIVE: Concerns exist about late ventricular dysfunction and tricuspidvalve (TV) function in patients with hypoplastic left heart syndrome (HLHS) palliatedinitially with a right ventricle-pulmonary artery conduit (RV-PA). The aim of thisstudy was to evaluate the mid-term RV, TV and neo-aortic valve (neo-AV) functionand clinical outcomes in patients with HLHS after completion of staged palliationbased on the type of shunt used at stage I reconstruction.METHODS: Retrospective review of records of all patients with HLHS who hadcompleted Fontan palliation between 2000 through 2007. The outcome variableswere: RV function, TV and neo-AV regurgitation (from latest post-Fontan echocardiogram),cardiac index (CI), pulmonary vascular resistance (PVR) and pressureTable 1. Latest Echocardiographic Data in Patients with HLHS After Completionof Staged Palliation Based on the Type of Shunt Used at Stage I ReconstructionShunt TypeRV FunctionNone orTrivial Mild Moderate Severe TotalFisher’sExact TestRV-PA conduit 20 (55.6%) 12 (33.3%) 3 (8.3%) 1 (2.8%) 36 (100%) 0.315BTS 53 (67.1%) 14 (17.7%) 7 (8.9%) 5 (6.3%) 79 (100%)TV regurgitationRV-PA conduit 15 (41.7%) 19 (52.8%) 2 (5.6%) 0 (0%) 36 (100%) 0.271BTS 20 (25.6%) 47 (60.3%) 10 (12.8%) 1 (1.3%) 78 (100%)Neo-aorticregurgitationRV-PA conduit 26 (83.9%) 5 (16.1%) 0 (0%) 0 (0%) 31 (100%) 0.441BTS 54 (75%) 18 (25%) 0 (0%) 0 (0%) 72 (100%)* AATS Member158

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