Optimal Z-score use in surgical decision-making in pulmonary atresia with intact ventricular septum.
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Date
2017Author
Awori, MN
Mehta, NP
Mitema, FO
Kebba, N
Type
ArticleLanguage
enMetadata
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OBJECTIVES:
In the surgical treatment of pulmonary atresia with intact ventricular septum, the size of the tricuspid valve annulus (as measured by z-scores) has emerged as a significant factor in deciding which repair to perform. Various tricuspid valve annulus z-scores are reported as "cutoffs" for successful biventricular repair. We aimed to determine whether the use of different z-score data sets contributed to the gross variation in "cutoffs" for successful biventricular repair reported in the literature.
METHODS:
A single search was made of PubMed using the "advanced" setting with the following search terms: pulmonary, atresia, intact, septum, z, and score. The filters "title" and "title/abstract" were used for the first four and last two terms, respectively; the instruction "AND" combined all terms. Articles that identified which z-score data set was used in patients with biventricular repairs were included.
RESULTS:
From 13 articles, 1,392 patients were studied, 410 (29.5%) of which achieved biventricular repair. Three z-score data sets were quoted; mean tricuspid valve annulus z-scores in biventricular repair patients ranged between -0.53 and -5.1. After correcting for discrepancies between z-score data sets, no study reported a mean tricuspid valve annulus z-score <-2.8 in biventricular repair patients and 83.3% reported mean tricuspid valve annuli z-scores >-1.7.
CONCLUSION:
The use of varied tricuspid valve annuli z-score data sets may have contributed to gross variations in reported "cutoffs" for successful biventricular repair. This could lead to inappropriate surgical pathway allocation.
URI
https://www.ncbi.nlm.nih.gov/pubmed/28520535http://journals.sagepub.com/doi/abs/10.1177/2150135117701407
http://hdl.handle.net/11295/101022
Citation
World J Pediatr Congenit Heart Surg. 2017 May;8(3):385-388.Publisher
University of Nairobi
Subject
atresia; pulmonary; z-scoreRights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10377]
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