Analysis and Prediction of Collateral Channels from Left Superior Vena Cava after Bilateral Bidirectional Cavopulmonary Anastomosis

Objectives: To analyze and predict collateral channels in bilateral bidirectional cavopulmonary anastomosis focused on that from left superior vena cava.Methods: 41 consecutive patients who all underwent bilateral bidirectional cavopulmonary anastomosis were enrolled the study.The number, shape, size, origin and entry, and course of collateral vessels from left superior vena cava were referred for evaluation based on 41 cardiac angiographies.The influential factors on the formation of collateral vessels were identified by binary logistic regression analysis.Results: The number of the left superior vena cava with collateral vessels was larger than right one, 22 versus 8 (X 2 = 10.303,P = 0.001).The medium-distal parts of left systemic vena were prone to development of collateral channel.The logic function with respect to the probability of left systemic venous collateral channel could be expressed as the linear expression of left systemic venous pressure x: 0.418x -7.111 (X 2 = 23.095,P < 0.001).Setting 17.0 mmHg of left systemic venous pressure as prediction cut-point to discriminate the occurrence of left collateral vessels, the predictive accuracy reached 85.7%.Conclusions: The left systemic venous pressure was an independent factor associated with left systemic venous collateral channel after bilateral bidirectional cavopulmonary shunt.It might be practically feasible to predict the development of collateral vessels according to systemic venous pressure.