@Article{chd.12722,
AUTHOR = {Vanessa Marie Hormaza, Mark Conaway, Daniel Scott Schneider, Jeffrey Eric Vergales},
TITLE = {The effect of right ventricular function on survival and morbidity following stage 2 palliation: An analysis of the single ventricle reconstruction trial public data set},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {2},
PAGES = {274--279},
URL = {http://www.techscience.com/schd/v14n2/38771},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Limited information is known on how right ventricular function affects 
outcomes after stage 2 palliation. We evaluated the impact of different right ventricular indices prior to stage 2 palliation on morbidity and mortality.<br/>
<b>Design:</b> Retrospective study design.<br/>
<b>Setting:</b> Pediatric Heart Network Single Ventricle Reconstruction Trial Public Data 
Set.<br/>
<b>Patient:</b> Any variant of stage 1 palliation and all anatomic hypoplastic left heart syndrome variants in the trial were evaluated. Echocardiograms prior to stage 2 palliation were analyzed and compared between those who failed and those who 
survived.<br/>
<b>Intervention:</b> None.<br/>
<b>Outcome measures:</b> Mortality was defined as death, listed for transplant, or transplanted after stage 2 palliation. Morbidity was evaluated as hospital length of stay 
and duration of intubation.<br/>
<b>Results:</b> A total of 283 patients met criteria for analysis. Of those, only 18 patients 
failed stage 2. Right ventricular fractional area change was less in those who failed 
(30% vs 34%, P = .039) and right ventricular indexed end‐diastolic volume and end‐
systolic volume were larger in those who failed (142.74 mL/ BSA<sup>1.3</sup> vs 111.29 mL/
BSA<sup>1.3</sup>, P = .023, 88.45 mL/ BSA<sup>1.3</sup> vs 62.75 mL/ BSA<sup>1.3</sup>, P = .025, respectively). 
Larger right ventricular indexed end‐diastolic and systolic volumes were associated 
with failure (OR 1.17 [1.01‐1.35] P = .021, OR 1.25 [1.03‐1.52] P = .021, respectively). 
Every 10% increase in RV ejection fraction had a 63% decrease in length of stay and 
a 68% decrease in duration of intubation (P = .014, and P = .039, respectively).<br/>
<b>Conclusion:</b> Patients with decreased right ventricular fractional area change and 
larger right ventricular indexed end‐diastolic and systolic volumes were more likely to 
fail stage 2 palliation. Those with preserved right ventricular function had a shorter 
hospital length of stay and duration of intubation. Echocardiographic measurements 
of right ventricular indices during the interstage period can be utilized to determine 
the prognosis following stage 2 palliation.},
DOI = {10.1111/chd.12722}
}