Younger age at operation is associated with reinterventions
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
The Warden procedure is a viable option for younger patients who require supracardiac partial anomalous pulmonary venous return (PAPVR) repair but are likely at higher risk for reintervention regardless of surgical technique.

This study aimed to describe outcomes of the Warden procedure with a single-patch repair cohort to serve as a control.

A retrospective cohort analysis of all patients at a single institution included patients undergoing either the Warden procedure or single-patch repair for PAPVR. Reintervention was defined as any catheter or surgical procedure on the superior vena cava (SVC) or pulmonary veins. Subgroup analysis was performed within the Warden cohort to evaluate for an association between an SVC patch and reintervention-free survival. In total, 158 patients (122 in the Warden group and 36 in the single-patch group) were identified.

--The median age at operation was younger for patients in the Warden cohort compared with patients in the single-patch cohort.

--One patient in each cohort died. One patient required reoperation after the Warden procedure for dehiscence of the intracardiac patch. Ten patients required transcatheter reinterventions.

--Reintervention-free survival was not different between patients in the Warden cohort and patients in the single-patch cohort or within the Warden cohort in patients with an SVC patch. When controlling for repair type, older age at repair was associated with longer reintervention-free survival.

The Warden procedure is a viable option for younger patients requiring supracardiac PAPVR repair, although these younger patients are likely at the greatest risk for reintervention regardless of surgical technique.

The Annals of Thoracic Surgery
Source: https://doi.org/10.1016/j.athoracsur.2020.05.143
Like
Comment
Share