Cardiol Young. 2026 Mar 10:1-8. doi: 10.1017/S1047951126111640. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to evaluate the results of interstage home monitoring program and its impact on outcomes after initial univentricular palliation.
METHODS: Patients with univentricular hearts who survived the initial palliation and were discharged from the hospital between 2013 and 2022 were included. The interstage outcomes in patients who received home monitoring program were evaluated, and survival was compared with those who did not.
RESULTS: Among 207 patients included, initial palliation consisted of 117 Norwood procedures, 58 aortopulmonary shunts, 28 ductal stents, and 7 pulmonary artery bandings. Home monitoring program was feasible in 187 (90.3%) patients. Survival after hospital discharge was higher in patients with home monitoring program compared to those without (93.0 vs. 82.9% at 180 days, p = 0.012). In 187 home monitoring program patients, events occurred in 98 patients (52.4%), including 77 low oxygen saturations (41.2%), 22 infections (11.7%), 10 stagnations of weight gains (5.3%), 6 hypoxaemic attacks (3.2%), and 4 side effects of vaccinations (2.1%). Additionally, 62 patients (37.1%) needed an unplanned hospital readmission. They were more frequent after ductal stent than other procedures (22.6 vs. 10.5%, p = 0.034) and had a lower weight at the time of bidirectional cavopulmonary shunt (5.0 vs. 5.4 kg, p = 0.021). Among them, 32 patients (47.1%) needed catheter interventions, and 10 (14.7%) underwent additional surgical procedures prior to bidirectional cavopulmonary shunt. Survival after bidirectional cavopulmonary shunt was similar between the groups (94.4 vs. 96.6% at 360 days, p = 0.807).
CONCLUSIONS: Home monitoring program improved interstage survival between stages I and II. However, unanticipated readmissions were frequent during this period, and various catheter and surgical interventions were mandatory before bidirectional cavopulmonary shunt.
PMID:41804896 | DOI:10.1017/S1047951126111640