Skip to main content
Erschienen in: Pediatric Cardiology 7/2016

29.06.2016 | Original Article

The Impact of Concomitant Left Ventricular Non-compaction with Congenital Heart Disease on Perioperative Outcomes

verfasst von: Preeti Ramachandran, Jessica G. Woo, Thomas D. Ryan, Roosevelt Bryant, Haleh C. Heydarian, John L. Jefferies, Jeffrey A. Towbin, Angela Lorts

Erschienen in: Pediatric Cardiology | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

Abstract

Left ventricular non-compaction (LVNC) is a heterogeneous myocardial disorder characterized by prominent trabeculations and inter-trabecular recesses which may occur in association with congenital heart disease (CHD). To date, few studies have been performed to assess whether the concomitant diagnosis of LVNC affects the outcomes of CHD surgery. A retrospective review of patients with LVNC with CHD (LVNC-CHD), 0–5 years of age, was conducted. Patients with CHD without LVNC (CHD-only) and 0–5 years of age with similar diagnosis distribution were selected for comparison. Perioperative data, including CHD diagnosis, operative course, and postoperative complications were collected and compared between groups. LVNC-CHD was diagnosed in 26 children. Of the 26 with LVNC-CHD, 20 underwent surgery and these patients were compared with 276 CHD-only controls. Median total length of stay in the hospital was 12.5 days (IQR 5.5–63 days) in LVNC-CHD compared to 5 days (IQR 3–10 days) in CHD-only (p < 0.005). Postoperative death, cardiac arrest, or need for ECMO or transplantation occurred in 6/20 (30 %) of the LVNC-CHD patients compared to 3/276 (1 %) of the CHD-only group (p < 0.0001). LVNC-CHD patients had significantly longer hospital length of stay and higher perioperative complications compared to CHD-only patients without myocardial abnormalities. Pediatric cardiac care teams should be cognizant of the possibility of the increased perioperative risk associated with concomitant LVNC. Future prospective studies are warranted.
Literatur
1.
Zurück zum Zitat Maron BJ, Towbin JA, Thiene G et al (2006) Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 113(14):1807–1816CrossRefPubMed Maron BJ, Towbin JA, Thiene G et al (2006) Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 113(14):1807–1816CrossRefPubMed
2.
Zurück zum Zitat Pignatelli RH, McMahon CJ, Dreyer WJ et al (2003) Clinical characterization of left ventricular noncompaction in children: a relatively common form of cardiomyopathy. Circulation 108(21):2672–2678CrossRefPubMed Pignatelli RH, McMahon CJ, Dreyer WJ et al (2003) Clinical characterization of left ventricular noncompaction in children: a relatively common form of cardiomyopathy. Circulation 108(21):2672–2678CrossRefPubMed
3.
Zurück zum Zitat Chin TK, Perloff JK, Williams RG et al (1990) Isolated noncompaction of left ventricular myocardium. A study of eight cases. Circulation 82(2):507–513CrossRefPubMed Chin TK, Perloff JK, Williams RG et al (1990) Isolated noncompaction of left ventricular myocardium. A study of eight cases. Circulation 82(2):507–513CrossRefPubMed
4.
Zurück zum Zitat Engberding R, Yelbuz TM, Breithardt G (2007) Isolated noncompaction of the left ventricular myocardium—a review of the literature two decades after the initial case description. Clin Res Cardiol 96(7):481–488CrossRefPubMed Engberding R, Yelbuz TM, Breithardt G (2007) Isolated noncompaction of the left ventricular myocardium—a review of the literature two decades after the initial case description. Clin Res Cardiol 96(7):481–488CrossRefPubMed
5.
Zurück zum Zitat Towbin JA, Lorts A, Jefferies JL (2015) Left ventricular non-compaction cardiomyopathy. Lancet 386(9995):813–825CrossRefPubMed Towbin JA, Lorts A, Jefferies JL (2015) Left ventricular non-compaction cardiomyopathy. Lancet 386(9995):813–825CrossRefPubMed
6.
Zurück zum Zitat Biagini E, Ragni L, Ferlito M et al (2006) Different types of cardiomyopathy associated with isolated ventricular noncompaction. Am J Cardiol 98(6):821–824CrossRefPubMed Biagini E, Ragni L, Ferlito M et al (2006) Different types of cardiomyopathy associated with isolated ventricular noncompaction. Am J Cardiol 98(6):821–824CrossRefPubMed
7.
Zurück zum Zitat Towbin JA (2010) Left ventricular noncompaction: a new form of heart failure. Heart Fail Clin 6(4):453–469, viii Towbin JA (2010) Left ventricular noncompaction: a new form of heart failure. Heart Fail Clin 6(4):453–469, viii
8.
Zurück zum Zitat Jenni R, Oechslin E, Schneider J et al (2001) Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy. Heart 86(6):666–671CrossRefPubMedPubMedCentral Jenni R, Oechslin E, Schneider J et al (2001) Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy. Heart 86(6):666–671CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Ichida F, Tsubata S, Bowles KR et al (2001) Novel gene mutations in patients with left ventricular noncompaction or Barth syndrome. Circulation 103(9):1256–1263CrossRefPubMed Ichida F, Tsubata S, Bowles KR et al (2001) Novel gene mutations in patients with left ventricular noncompaction or Barth syndrome. Circulation 103(9):1256–1263CrossRefPubMed
10.
Zurück zum Zitat Attenhofer Jost CH, Connolly HM, Warnes CA et al (2004) Noncompacted myocardium in Ebstein’s anomaly: initial description in three patients. J Am Soc Echocardiogr 17(6):677–680CrossRefPubMed Attenhofer Jost CH, Connolly HM, Warnes CA et al (2004) Noncompacted myocardium in Ebstein’s anomaly: initial description in three patients. J Am Soc Echocardiogr 17(6):677–680CrossRefPubMed
11.
Zurück zum Zitat Zuckerman WA, Richmond ME, Singh RK et al (2011) Left-ventricular noncompaction in a pediatric population: predictors of survival. Pediatr Cardiol 32(4):406–412CrossRefPubMed Zuckerman WA, Richmond ME, Singh RK et al (2011) Left-ventricular noncompaction in a pediatric population: predictors of survival. Pediatr Cardiol 32(4):406–412CrossRefPubMed
12.
Zurück zum Zitat Stahli BE, Gebhard C, Biaggi P et al (2013) Left ventricular non-compaction: prevalence in congenital heart disease. Int J Cardiol 167(6):2477–2481CrossRefPubMed Stahli BE, Gebhard C, Biaggi P et al (2013) Left ventricular non-compaction: prevalence in congenital heart disease. Int J Cardiol 167(6):2477–2481CrossRefPubMed
13.
Zurück zum Zitat Madan S, Mandal S, Bost JE et al (2012) Noncompaction cardiomyopathy in children with congenital heart disease: evaluation using cardiovascular magnetic resonance imaging. Pediatr Cardiol 33(2):215–221CrossRefPubMed Madan S, Mandal S, Bost JE et al (2012) Noncompaction cardiomyopathy in children with congenital heart disease: evaluation using cardiovascular magnetic resonance imaging. Pediatr Cardiol 33(2):215–221CrossRefPubMed
14.
Zurück zum Zitat Hughes ML, Carstensen B, Wilkinson JL et al (2007) Angiographic diagnosis, prevalence and outcomes for left ventricular noncompaction in children with congenital cardiac disease. Cardiol Young 17(1):56–63CrossRefPubMed Hughes ML, Carstensen B, Wilkinson JL et al (2007) Angiographic diagnosis, prevalence and outcomes for left ventricular noncompaction in children with congenital cardiac disease. Cardiol Young 17(1):56–63CrossRefPubMed
15.
Zurück zum Zitat Attenhofer Jost CH, Connolly HM, O’Leary PW et al (2005) Left heart lesions in patients with Ebstein anomaly. Mayo Clin Proc 80(3):361–368CrossRefPubMed Attenhofer Jost CH, Connolly HM, O’Leary PW et al (2005) Left heart lesions in patients with Ebstein anomaly. Mayo Clin Proc 80(3):361–368CrossRefPubMed
16.
Zurück zum Zitat Jacobs JP, Jacobs ML, Lacour-Gayet FG et al (2009) Stratification of complexity improves the utility and accuracy of outcomes analysis in a Multi-Institutional Congenital Heart Surgery Database: Application of the Risk Adjustment in Congenital Heart Surgery (RACHS-1) and Aristotle Systems in the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database. Pediatr Cardiol 30(8):1117–1130CrossRefPubMed Jacobs JP, Jacobs ML, Lacour-Gayet FG et al (2009) Stratification of complexity improves the utility and accuracy of outcomes analysis in a Multi-Institutional Congenital Heart Surgery Database: Application of the Risk Adjustment in Congenital Heart Surgery (RACHS-1) and Aristotle Systems in the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database. Pediatr Cardiol 30(8):1117–1130CrossRefPubMed
17.
Zurück zum Zitat Jenkins KJ (2004) Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 7:180–184CrossRefPubMed Jenkins KJ (2004) Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 7:180–184CrossRefPubMed
18.
Zurück zum Zitat Jenkins KJ, Gauvreau K (2002) Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenital Heart Surgery (RACHS-1) method. J Thorac Cardiovasc Surg 124(1):97–104CrossRefPubMed Jenkins KJ, Gauvreau K (2002) Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenital Heart Surgery (RACHS-1) method. J Thorac Cardiovasc Surg 124(1):97–104CrossRefPubMed
19.
Zurück zum Zitat Ichida F, Hamamichi Y, Miyawaki T et al (1999) Clinical features of isolated noncompaction of the ventricular myocardium: long-term clinical course, hemodynamic properties, and genetic background. J Am Coll Cardiol 34(1):233–240CrossRefPubMed Ichida F, Hamamichi Y, Miyawaki T et al (1999) Clinical features of isolated noncompaction of the ventricular myocardium: long-term clinical course, hemodynamic properties, and genetic background. J Am Coll Cardiol 34(1):233–240CrossRefPubMed
20.
Zurück zum Zitat Steffel J, Kobza R, Oechslin E et al (2009) Electrocardiographic characteristics at initial diagnosis in patients with isolated left ventricular noncompaction. Am J Cardiol 104(7):984–989CrossRefPubMed Steffel J, Kobza R, Oechslin E et al (2009) Electrocardiographic characteristics at initial diagnosis in patients with isolated left ventricular noncompaction. Am J Cardiol 104(7):984–989CrossRefPubMed
21.
Zurück zum Zitat Towbin JA (2014) Ion channel dysfunction associated with arrhythmia, ventricular noncompaction, and mitral valve prolapse: a new overlapping phenotype. J Am Coll Cardiol 64(8):768–771CrossRefPubMedPubMedCentral Towbin JA (2014) Ion channel dysfunction associated with arrhythmia, ventricular noncompaction, and mitral valve prolapse: a new overlapping phenotype. J Am Coll Cardiol 64(8):768–771CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Milano A, Vermeer AM, Lodder EM et al (2014) HCN4 mutations in multiple families with bradycardia and left ventricular noncompaction cardiomyopathy. J Am Coll Cardiol 64(8):745–756CrossRefPubMed Milano A, Vermeer AM, Lodder EM et al (2014) HCN4 mutations in multiple families with bradycardia and left ventricular noncompaction cardiomyopathy. J Am Coll Cardiol 64(8):745–756CrossRefPubMed
23.
Zurück zum Zitat Delaney JW, Moltedo JM, Dziura JD et al (2006) Early postoperative arrhythmias after pediatric cardiac surgery. J Thorac Cardiovasc Surg 131(6):1296–1300CrossRefPubMed Delaney JW, Moltedo JM, Dziura JD et al (2006) Early postoperative arrhythmias after pediatric cardiac surgery. J Thorac Cardiovasc Surg 131(6):1296–1300CrossRefPubMed
24.
Zurück zum Zitat Payne L, Zeigler VL, Gillette PC (2011) Acute cardiac arrhythmias following surgery for congenital heart disease: mechanisms, diagnostic tools, and management. Crit Care Nurs Clin North Am 23(2):255–272CrossRefPubMed Payne L, Zeigler VL, Gillette PC (2011) Acute cardiac arrhythmias following surgery for congenital heart disease: mechanisms, diagnostic tools, and management. Crit Care Nurs Clin North Am 23(2):255–272CrossRefPubMed
Metadaten
Titel
The Impact of Concomitant Left Ventricular Non-compaction with Congenital Heart Disease on Perioperative Outcomes
verfasst von
Preeti Ramachandran
Jessica G. Woo
Thomas D. Ryan
Roosevelt Bryant
Haleh C. Heydarian
John L. Jefferies
Jeffrey A. Towbin
Angela Lorts
Publikationsdatum
29.06.2016
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 7/2016
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-016-1435-2

Weitere Artikel der Ausgabe 7/2016

Pediatric Cardiology 7/2016 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.