Clinical course and outcome of children with single ventricle physiology at King Chulalongkorn Memorial Hospital.

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dc.contributor.authorKhongphatthanayothin, Apichaien_US
dc.contributor.authorRattanawilaisak, Kanokornen_US
dc.contributor.authorBenjacholamas, Vichaien_US
dc.contributor.authorNumchaisiri, Chuleen_US
dc.contributor.authorSirichonkolthong, Boonchuen_US
dc.contributor.authorChotivitayatarakorn, Pairojen_US
dc.contributor.authorLertsapcharoen, Pornthepen_US
dc.date.accessioned2009-05-27T18:33:12Z
dc.date.available2009-05-27T18:33:12Z
dc.date.issued2006-09-15en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractBACKGROUND: Children with single ventricle physiology comprise 10% of all children with congenital heart disease (CHD) and one-third of children with cyanotic CHD seen at King Chulalongkorn Memorial Hospital. The prognosis of these children is generally thought to be poor but no study of the outcome has previously been done in this hospital and in Thailand. OBJECTIVES: To study the clinical course and outcome of children with single ventricle physiology at King Chulalongkorn Memorial Hospital during the current era. MATERIAL AND METHOD: One hundred and seventeen patients with single ventricle physiology were initially seen at this hospital during the year 1999-2001. Retrospective chart reviews were carried out in 90 children with available medical records. The status of the patients was determined in 2003 at clinic visits, by phone calls and mail. RESULTS: The main diagnoses were tricuspid atresia (TA, n = 10), pulmonary atresia with intact ventricular septum (PA/IVS, n = 16), single ventricle associated with cardiac malposition or heterotaxy syndrome (malposition, n = 35), hypoplastic left heart syndrome (HLHS, n = 11) and other complex single ventricle (others, n = 18). Most children did not have other major anomalies. Survival of patients with TA and PA/IVS was approximately 92 and 87% at 1 and 4 years, respectively. For patients in the other three groups, 1 and 4 year survival was 69 and 42%, respectively. Patients with HLHS had the worse survival, partly because of decisions not to pursue further treatments by the parents. Among HLHS patients who underwent Norwood procedure, the 1 and 4 year survival were 83% and 42%, respectively. Approximately 40 and 90% of all patients underwent heart surgery at 1 and 4 years follow-up, respectively. CONCLUSION: Despite limited resource, the short-term outcome of Thai children with single morphologic left ventricle (TA and PA/IVS) is reasonably good. Timely evaluation and treatment of these children toward Fontan procedure should be ensured. After proper discussion with the parents, palliative care is still acceptable for patients with single morphologic right ventricle or other complex single ventricle due to poor survival in the current era. As access to health care improves, re-evaluation of these outcomes is necessary to find the best strategy for the management of these patients.en_US
dc.description.affiliationDepartment of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. apichaik@yahoo.comen_US
dc.identifier.citationKhongphatthanayothin A, Rattanawilaisak K, Benjacholamas V, Numchaisiri C, Sirichonkolthong B, Chotivitayatarakorn P, Lertsapcharoen P. Clinical course and outcome of children with single ventricle physiology at King Chulalongkorn Memorial Hospital. Journal of the Medical Association of Thailand. 2006 Sep; 89(9): 1420-6en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/39377
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshFemaleen_US
dc.subject.meshFontan Procedureen_US
dc.subject.meshHeart Defects, Congenital --diagnosisen_US
dc.subject.meshHeart Ventricles --abnormalitiesen_US
dc.subject.meshHospitalsen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshMaleen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshThailanden_US
dc.subject.meshTreatment Outcomeen_US
dc.titleClinical course and outcome of children with single ventricle physiology at King Chulalongkorn Memorial Hospital.en_US
dc.typeJournal Articleen_US
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