TY - JOUR
AU1 - Ponzoni, Matteo
AU2 - Azzolina, Danila
AU3 - Vedovelli, Luca
AU4 - Gregori, Dario
AU5 - Di Salvo, Giovanni
AU6 - D’Udekem, Yves
AU7 - Vida, Vladimiro
AU8 - Padalino, Massimo A
AB - OBJECTIVESA conclusive interpretation of the role of ventricular dominance in outcomes after Fontan palliation has not been formulated yet. We conducted a systematic review and meta-analysis of scientific literature to give an insight into the impact of ventricular morphology in single-ventricle palliation, focusing on its influence on survival, morbidities, ventricular performance and functional capacity.METHODSA systematic review of PubMed, Web of Science and Scopus databases was performed. A random-effect meta-analysis was conducted, and survival data were reconstructed using the published Kaplan–Meier survival curves.RESULTSTwenty-seven studies were selected, for a total of 4529 left-dominant versus 4844 right-dominant patients. Estimated survival at 1, 5, 10, 20 and 30 years of follow-up was 0.99 [95% confidence interval (CI) = 0.98–0.99], 0.95 [95% CI = 0.94–0.96], 0.92 [95% CI = 0.91–0.93], 0.86 [95% CI = 0.84–0.88] and 0.68 [95% CI = 0.65–0.83] for left-dominant patients and 0.94 [95% CI = 0.93–0.95], 0.89 [95% CI = 0.88–0.9], 0.85 [95% CI = 0.83–0.87], 0.69 [95% CI = 0.63–0.75] and 0.59 [95% CI = 0.5–0.69] for right-dominant patients, respectively. Survival was statistically lower for right-dominant patients (P < 0.001), with an hazard ratio for the mortality of 2.38 (2.03–2.80); also, they displayed significantly longer hospital stay, worse ventricular function, larger ventricular volumes and a higher incidence of moderate or severe atrioventricular valve regurgitation when compared to left-dominant patients.CONCLUSIONSAccording to our meta-analysis, the morphology of the dominant ventricle has a significant impact on outcomes after Fontan palliation. Right-dominant patients experience an inferior long-term survival when the anatomical right ventricle is included in the systemic circulation.
TI - Ventricular morphology of single-ventricle hearts has a significant impact on outcomes after Fontan palliation: a meta-analysis
JF - European Journal of Cardio-Thoracic Surgery
DO - 10.1093/ejcts/ezac535
DA - 2022-11-11
UR - https://www.deepdyve.com/lp/oxford-university-press/ventricular-morphology-of-single-ventricle-hearts-has-a-significant-bZJJy5MbWQ
SP - 1
EP - 1
VL - 62
IS - 6
DP - DeepDyve
ER -