{"title":"术前西地那非治疗方坦术后长期胸腔积液的回顾性研究。","authors":"Dicky Fakhri, Pribadi Wiranda Busro, Budi Rahmat, Salomo Purba, Oktavia Lilyasari, Toshihide Asou","doi":"10.4103/apc.apc_76_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>By rerouting the systemic venous return into the pulmonary circulation, the Fontan operation is perhaps the most effective palliative procedure in patients with complex congenital heart disease. The Fontan, however, still comes with several significant complications and morbidities, one of them being postoperative prolonged pleural effusion. In our center from 2017 to 2021, 10% of all our patients who underwent Fontan operation developed prolonged pleural effusion. With this study, we aimed to analyze the preoperative use of sildenafil for 6 months and its role in prolonged pleural effusion after the Fontan operation.</p><p><strong>Materials and methods: </strong>In total, 158 patients were included in the analysis. The cohort was divided into patients who developed prolonged pleural effusion after Fontan surgery (<i>n</i> = 17) and those who did not (<i>n</i> = 141). We analyzed several risk factors and the history of sildenafil use in each group in the cohort. We found that patients who used sildenafil for at least 6 months prior to Fontan surgery versus those who did not use (<i>n</i> = 112 vs. <i>n</i> = 46) were found to be at lower risk of developing prolonged pleural effusion (odds ratio [OR]: 0.32 [confidence interval 95%: 0.11-0.88], <i>P</i> = 0.027).</p><p><strong>Conclusion: </strong>Preoperative administration of sildenafil for at least 6 months before Fontan might reduce the risk of postoperative prolonged pleural effusion.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10856614/pdf/","citationCount":"0","resultStr":"{\"title\":\"Retrospective study of preoperative sildenafil in prolonged pleural effusion after Fontan.\",\"authors\":\"Dicky Fakhri, Pribadi Wiranda Busro, Budi Rahmat, Salomo Purba, Oktavia Lilyasari, Toshihide Asou\",\"doi\":\"10.4103/apc.apc_76_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>By rerouting the systemic venous return into the pulmonary circulation, the Fontan operation is perhaps the most effective palliative procedure in patients with complex congenital heart disease. The Fontan, however, still comes with several significant complications and morbidities, one of them being postoperative prolonged pleural effusion. In our center from 2017 to 2021, 10% of all our patients who underwent Fontan operation developed prolonged pleural effusion. With this study, we aimed to analyze the preoperative use of sildenafil for 6 months and its role in prolonged pleural effusion after the Fontan operation.</p><p><strong>Materials and methods: </strong>In total, 158 patients were included in the analysis. The cohort was divided into patients who developed prolonged pleural effusion after Fontan surgery (<i>n</i> = 17) and those who did not (<i>n</i> = 141). We analyzed several risk factors and the history of sildenafil use in each group in the cohort. We found that patients who used sildenafil for at least 6 months prior to Fontan surgery versus those who did not use (<i>n</i> = 112 vs. <i>n</i> = 46) were found to be at lower risk of developing prolonged pleural effusion (odds ratio [OR]: 0.32 [confidence interval 95%: 0.11-0.88], <i>P</i> = 0.027).</p><p><strong>Conclusion: </strong>Preoperative administration of sildenafil for at least 6 months before Fontan might reduce the risk of postoperative prolonged pleural effusion.</p>\",\"PeriodicalId\":8026,\"journal\":{\"name\":\"Annals of Pediatric Cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10856614/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Pediatric Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/apc.apc_76_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Pediatric Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/apc.apc_76_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/5 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景:通过将全身静脉回流改道进入肺循环,丰坦手术可能是复杂先天性心脏病患者最有效的姑息性手术。然而,丰坦手术仍伴随着一些重大并发症和发病率,其中之一就是术后长期胸腔积液。从2017年到2021年,在我们中心接受丰坦手术的所有患者中,有10%出现了胸腔积液时间延长的情况。通过这项研究,我们旨在分析术前使用西地那非6个月的情况及其在丰坦手术后胸腔积液时间延长中的作用:共有 158 名患者纳入分析。该组患者分为在丰坦手术后出现长期胸腔积液的患者(17 人)和未出现长期胸腔积液的患者(141 人)。我们分析了队列中每组患者的几个风险因素和西地那非使用史。我们发现,在丰坦手术前使用西地那非至少6个月的患者与未使用西地那非的患者(n = 112 vs. n = 46)相比,发生长期胸腔积液的风险较低(几率比[OR]:0.32[置信区间95%:0.11-0.88],P = 0.027):结论:在Fontan手术前服用西地那非至少6个月可降低术后长期胸腔积液的风险。
Retrospective study of preoperative sildenafil in prolonged pleural effusion after Fontan.
Background: By rerouting the systemic venous return into the pulmonary circulation, the Fontan operation is perhaps the most effective palliative procedure in patients with complex congenital heart disease. The Fontan, however, still comes with several significant complications and morbidities, one of them being postoperative prolonged pleural effusion. In our center from 2017 to 2021, 10% of all our patients who underwent Fontan operation developed prolonged pleural effusion. With this study, we aimed to analyze the preoperative use of sildenafil for 6 months and its role in prolonged pleural effusion after the Fontan operation.
Materials and methods: In total, 158 patients were included in the analysis. The cohort was divided into patients who developed prolonged pleural effusion after Fontan surgery (n = 17) and those who did not (n = 141). We analyzed several risk factors and the history of sildenafil use in each group in the cohort. We found that patients who used sildenafil for at least 6 months prior to Fontan surgery versus those who did not use (n = 112 vs. n = 46) were found to be at lower risk of developing prolonged pleural effusion (odds ratio [OR]: 0.32 [confidence interval 95%: 0.11-0.88], P = 0.027).
Conclusion: Preoperative administration of sildenafil for at least 6 months before Fontan might reduce the risk of postoperative prolonged pleural effusion.