Resumo

NARANJO UGALDE, Alfredo Mario et al. Postoperative mortality and morbidity found in children with univentricular heart according to the morphological diagnosis. Rev Cubana Pediatr [online]. 2013, vol.85, n.3, pp. 346-355. ISSN 0034-7531.

Introduction: tricuspid atresia is the cyanotic congenital heart disease that more frequently involves the indication of univentricular heart surgery. The surgical treatment consists of separating the systemic circulation from the pulmonary one through total cavopulmonary shunt (Fontan procedure). Objective: to compare the evolution of Fontan procedure postoperatively from January 1990 to December 2010 with the morphological diagnosis. Methods: the children were divided into 2 study groups (Triscupid atresia and Triscupid atresia-free with diagnosis different from that of tricuspid atresia). Chi square and Student's tests helped to analyze qualitative and quantitative variables for significance level £ 0.05. Results: tricuspid atresia was observed in 31 patients and 61 tricuspid atresia-free. In the postoperative period, 68 patients suffered complications, 23 with tricuspid atresia (74.2 %) and 45 diagnosed with a disease other than tricuspid atresia (73.7 %). Thirty patients had persistent pleural effusions during the postoperative period, 11 (35.5 %) and 19 (31.4) in the tricuspid atresia group and in the tricuspid atresia-free group respectively. Eighteen patients died and no significant association was found in neither of the groups. During the follow-up, the most frequent cause of morbidity was reduced functional capacity either moderate or severe in 13 patients with tricuspid atresia (44.8 %) and in 20 children (44.4 %) from the other group (p= 1). Conclusions: Fontan procedure is a surgical option that allows the survival of patients with univentricular heart associated to long-term postoperative morbidity. The morphological diagnosis of tricuspid atresia is not related to morbility and mortality.

Palavras-chave : congenital heart disease; cavopulmonary shunt; univentricular.

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