Abstract 12477: Association of Age and Outcome After Bidirectional Cavopulmonary Anastomosis
Introduction: The Glenn procedure has traditionally been performed between 4-6 months of age. Several studies have investigated the benefits of performing the procedure earlier, to shorten the inter-stage period. No studies have specifically looked the unintended consequences of early Glenn procedures (< 4 months) related to post-operative outcomes.
Hypothesis: We hypothesized that after the Glenn procedure, younger patients would have a longer post-operative length of stay.
Methods: All patients undergoing the Glenn procedure between 1/2010 and 7/2015 were included in this retrospective cohort study. Demographic data, including baseline saturations, medications, length of intubation and chest tube drainage were recorded. Mean post-operative length of stay was calculated. Standard descriptive statistics were used. A univariable analysis was conducted using the appropriate test based on data distribution. A multivariable analysis was then completed using predictors from the univariable analysis.
Results: Over the study period, 50 patients were included. Patients were separated into two cohorts[≥4 months (28) and <4 months (22)]. Other than height and weight, the two cohorts were indistinguishable in their pre-operative saturation, medications, catheterization hemodynamics, atrioventricular valve regurgitation and ventricular function. Length of intubation and chest tube drainage were not different between the cohorts. Younger age was associated with longer post-operative length of stay [mean 14.6 (±15) vs. 7.7(±5.1) days, p=0.03]. In a multivariable regression analysis, in addition to ventricular dysfunction (B coefficient 8.8, p=0.05), Glenn procedures performed before 4 months were independently associated with longer length of stay (B coefficient -6.9, p=0.03).
Conclusion: We found that elective Glenn procedures performed after 4 months of age had improved outcomes compared to a younger cohort. These findings suggest that balancing timing of surgery to decrease the inter-stage period should take into consideration differences in post-operative recovery with early operations.
Author Disclosures: A.M. Koth: None. C.A. Algaze: None. S. Hao: None. A.Y. Shin: None.
- © 2016 by American Heart Association, Inc.