HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Feza Nurozler Scott M. Bradley Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nurozler, F. Articles by Bradley, S. M. Search for Related Content PubMed PubMed Citation Articles by Nurozler, F. Articles by Bradley, S. M.

Eur J Cardiothorac Surg 2000;18:540-544
© 2000 Elsevier Science NL

Considerations in biventricular repair after the Norwood procedure

Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA

Received 30 March 2000; received in revised form 26 June 2000; accepted 15 August 2000.

Corresponding author. Department of Cardiothoracic Surgery, Columbia University Presbyterian Medical Center, Milstein Building 7-435, 177 Fort Washington Ave, NY 10032, USA. Fax: +1-212-305-2439
e-mail: feza_n{at}hotmail.com

Objective: The Norwood procedure can be applicable as a first stage palliation in children who can eventually undergo a biventricular repair. Although usual management of these patients is a primary neonatal repair, in selected patients staged approach with a Norwood procedure in the neonatal period followed by a Rastelli procedure in the infancy for conversion to two-ventricle physiology has been used alternatively. Methods: We report our experiences on two infants who underwent a previous palliation with the Norwood procedure for lesions other than hypoplastic left heart syndrome and converted to two-ventricle physiology by the use of a Rastelli-type procedure. This report examines considerations in biventricular repair after the Norwood procedure especially need for ventricular septal defect enlargement and approach to placement of the right ventricle to pulmonary artery conduit. Results: Both of the infants who underwent staged approach with an initial Norwood procedure for lesions other than hypoplastic left heart syndrome survived the operations and were clinically well at mid-term follow-up. Conclusion: In selected patients, the staged approach is an alternative in management of malformations other than hypoplastic left heart syndrome which share the important physiologic features of aortic outlet obstruction and ductal dependency of systemic circulation. We recommend routine enlargement of ventricular septal defect and proper positioning of the conduit at the time of subsequent biventricular repair.

Key Words: Critical left ventricular outflow tract obstruction • Staged approach with an initial the Norwood procedure • Biventricular repair

This article has been cited by other articles:

				J. M. Pearl, L. W. Cripe, and P. B. Manning Biventricular repair after Norwood palliation Ann. Thorac. Surg., January 1, 2003; 75(1): 132 - 137. [Abstract] [Full Text] [PDF]