Outcomes and risk factors for listing for heart transplantation after the Norwood procedure: An analysis of the Single Ventricle Reconstruction Trial.
Kulkarni A, Neugebauer R, et al.Journal of Heart & Lung Transplantation 2016; 35(3): 306-311.
Aims
To identify predictors for the decision to list for heart transplantation (HT) among patients with a single ventricle who had undergone the Norwood procedure.
Interventions
The public use data set from the Single Ventricle Reconstruction (SVR) trial was utilised to collect outcomes after listing to the last known follow-up and potential risk factors for listing for HT.
Participants
555 patients from the SVR trial who were listed for HT and were alive without listing.
Outcomes
Measured oucomes included type of shunt, age at Norwood, extracorporeal membrane oxygenation use before and after the Norwood, ventilated days, intensive care unit days, complications, catheterizations, other surgeries during Norwood hospitalization, length of stay and number of medications at discharge from the Norwood hospitalization.
Follow-up
Average follow-up was 2.1 years (Range: 1.7-2.9 years)
CET Conclusions
This paper makes use of data from the Single Ventricle Trial, published in 2010, comparing outcomes between the Norwood procedure with a modified Blalock-Taussig Shunt and a right ventricle-to-pulmonary artery shunt in infants with single ventricle. The trial was conducted between 2005-2009 and the data became public in 2013. Median time to listing for heart transplant after the Norwood procedure was 110 days (33 listed of 555 randomised, 6%). 18 patients (55%) received a heart transplant by the end of the study follow-up, and the median time from listing to transplant was 25 days. Waiting list mortality was high (39%), as was post-transplant mortality (33%, median 166 days). The paper identified variables associated with a more complex course following Norwood procedure as risk factors for listing.
Quality notes
Quality assessment not appropriate.
Trial registration
None