Single-Ventricle Disease: Long-Term Outcomes and Global Morbidity in the Single Ventricle Reconstruction Trial - PubMed
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- #Cardiac Surgery
- #Single-Ventricle Disease
- #Pediatric Cardiology
- The Single Ventricle Reconstruction (SVR) trial compared outcomes between right ventricle-to-pulmonary artery shunt (RVPAS) and modified Blalock-Taussig-Thomas shunt.
- Initial 1-year transplant-free survival favored RVPAS, but the benefit diminished over time.
- A novel hierarchically ranked composite endpoint was used to assess global morbidity and longitudinal outcomes.
- 87% of participants experienced death or major morbidity over 16 years of follow-up.
- Shunt type interacted with pre-Norwood tricuspid regurgitation severity, affecting outcomes.
- RVPAS showed worse outcomes in participants with moderate or severe pre-Norwood tricuspid regurgitation.
- Prematurity and site were significant independent predictors of worse outcomes.
- Few patients with single ventricles survived without major morbidity.
- The study highlights the need for future investigation into shunt type and tricuspid regurgitation interaction.