Abstract Body (Do not enter title and authors here): Introduction
Pulmonary atresia with intact ventricular septum (PAIVS) patients may proceed down a single (SV) or biventricular (BV) pathway. We evaluated the total interventional burden of both pathways including after either end-state was reached.
Hypothesis
SV patients will have more interventions in comparison to BV patients.
Goals
Assess the nature of interventions in PAIVS.
Methods
Retrospective review of PAIVS patients from 1995-2020 who achieved SV (Fontan completion) or BV (normal saturations with no significant shunts) end-state. Demographic, procedural, and follow-up details were collected. Descriptive statistics were used and Kaplan-Meier analysis of freedom from reintervention was performed.
Results
Of 79 patients who reached end-state, 40 (51%) were SV and 39 (49%) were BV. Total median in-hospital time was 48 [31-78] days and 18 [12-35] days for SV and BV (p<0.01). The ratio of in-hospital days to total follow-up was a median of 1.7% [0.9-2.7] for SV and 0.4% [0.3-0.8] for BV (p<0.01). SV and BV cohorts had an overall median of 4 [3-5] and 3 [2-4] interventions, respectively (p<0.01). Interventions and their relationship to end-state are shown in Table 1. The SV and BV groups achieved end-state at a median of 2.9 [2.3-3.6] and 2.1 [0.2-8.8] years (p=0.01) (Figure 1A). Median follow up in years after achieving end-state was similar between groups {7 [2.7-15.8] in SV and 7.4 [4.2-13.4] for BV (p=0.11)}. After end-state, there was no difference in the proportion of patients requiring reinterventions (17 (43%) SV and 12 (31%) BV, p>0.05). Freedom from reintervention at 15-years was 44.1% in the SV group and 64.3% in the BV group (p=0.11) (Figure 1B) with one late SV death.
Conclusions
PAIVS therapy requires multiple interventions to achieve both SV and BV repair. While SV patients undergo more interventions and spend more days in the hospital, reinterventions and 15-year freedom from reintervention were comparable between groups with equivalent follow up.