Why the study?
Superior cavopulmonary connection (SCPC) surgeries are associated with residual lesions and reintervention, and contemporary practice increasingly uses strategies to delay initial surgery. The effects of these factors on the likelihood and outcomes of post-SCPC diagnostic and interventional catheterization had not been described.
Does post-SCPC catheterization and transcatheter reintervention affect hospital mortality, length of stay, and adverse events in patients undergoing superior cavopulmonary connection surgery?
Observational (n=170)
No
Does post-SCPC catheterization and transcatheter reintervention affect hospital mortality, length of stay, and adverse events in patients undergoing superior cavopulmonary connection surgery?
Post-operative catheterization and reintervention for residual lesions are common during the index hospitalization after SCPC surgery, resulting in comparable survival to discharge as unaffected patients when lesions are treated, despite prolonged length of stay.
Answers are grounded in this paper and cite their sources.
Pre-discharge catheterization after SCPC identifies reinterventions in select cases; leaves open whether risk-based surveillance improves outcomes.
BACKGROUND: Despite low operative mortality, superior cavopulmonary connection (SCPC) surgeries are associated with residual lesions and a burden of reintervention. Current practice has trended toward increased utilization of tactics to delay initial surgery (e.g., ductal stent or hybrid strategies). To our knowledge, the effects of these associations on likelihood of residual lesions and post-SCPC diagnostic and interventional catheterization (and their outcomes) have not been described. AIMS: To describe the likelihood of post-SCPC catheterization, reintervention, and outcomes of these procedures. METHODS: A single-center case series of patients undergoing SCPC 1/1/2020-3/30/2024 was performed describing the likelihood of requiring catheterization before hospital discharge, interventions performed, and outcomes (adverse events, length of stay, and mortality). Secondary analyses explored differences between patients undergoing transcatheter interventions versus diagnostic studies, regarding both indications and outcomes. RESULTS: Of 170 total SCPC operations, 26% underwent catheterization during that hospitalization, with 19% requiring reintervention. Prematurity, shorter height, younger age, and ongoing enteral feeding were associated with a higher likelihood of a post-SCPC catheterization (p < 0.05). The majority of interventions were on the left pulmonary artery (47%) or cavopulmonary anastomosis (33%). Surgical mortality was not significantly different between subjects who underwent transcatheter intervention after SCPC (3%) and those who did not undergo catheterization (1%, p = 0.38), but the likelihood was higher in those who underwent catheterization but did not undergo intervention (17%, p = 0.01). Hospital and intensive care unit length of stay were longer for subjects who underwent catheterization (p = 0.001) and intervention (p = 0.01) compared to those who did not. CONCLUSION: Catheterization remains common after SCPC, with the majority identifying a residual lesion that was treated. With treatment of residual lesions, survival to discharge is not significantly different than unaffected patients, but length of stay is prolonged which may indicate persistent morbidity.
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Morrison et al. (2026) conducted an observational in Superior cavopulmonary connection (SCPC) surgery (n=170). Post-SCPC transcatheter intervention vs. No post-SCPC catheterization was evaluated on Surgical mortality (p=0.38).
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