| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2003;23:728-734
© 2003 Elsevier Science NL
Department of Paediatric Cardiac Surgery, Collegium Medicum, Jagiellonian University, 265 Wielicka St., 30-663 Cracow, Poland
Received 1 October 2002; received in revised form 20 January 2003; accepted 23 January 2003.
* Corresponding author. Tel.: +48-12-568-1023; fax: +48-12-657-3947
e-mail: mimalec{at}cyf-kr.edu.pl
Objective: The aim of this study was to assess changes in early and late haemodynamic status after the Norwood procedure (NP), caused by the implementation of right ventricle-to-pulmonary artery shunt (RV-PA). Methods: A consecutive series of 68 children with hypoplastic left heart syndrome underwent NP: Group 1 (n=31) with the application of a modified Blalock-Taussig shunt and Group 2 (n=37) with RV-PA. Haemodynamic data from the early postoperative period (72 h after the operation) and cardiac catheterisation data, as well as blood tests before the hemi-Fontan procedure (HF) were analysed. Univariate (
2 test, Mann–Whitney's and Student's t-tests) and multiple regression analysis were carried out. Results: In Group 1, circulatory collapse requiring resuscitation occurred in 15 (48.4%) children, within 72 h after the procedure. The resuscitation was unsuccessful in nine (29%) cases. The operative mortality (30 days) was 35%. In Group 2, two (5%) children died within the early and two (5%) within the late postoperative period. The postoperative course in the remaining children from Group 2 was uneventful. In Group 2 there was a significantly higher mean diastolic pressure after NP (P<0.05). The arterial pulse pressure after NP was significantly lower in Group 2 (P<0.05). Before HF, the application of RV-PA was associated with a lower Qp:Qs ratio (P=0.020), lower aortic pulse pressure (P=0.004) and lower aortic oxygen saturation (P=0.039). Conclusions: A stable haemodynamic status due to independent coronary perfusion, higher diastolic and lower pulse pressure is the most advantageous effect of RV-PA, resulting in a lower mortality and morbidity after NP. A lower Qp:Qs ratio eliminates the danger of the ventricular volume overload and ensures good conditions for the development of the pulmonary circulation before HF.
Key Words: Hypoplastic left heart syndrome • Norwood procedure • Haemodynamic status
This article has been cited by other articles:
|
|
 |
|
  J. A. Williams, A. K. Bansal, B. J. Kim, L. U. Nwakanma, N. D. Patel, A. K. Seth, D. E. Alejo, V. L. Gott, L. A. Vricella, W. A. Baumgartner, et al. Two Thousand Blalock-Taussig Shunts: A Six-Decade Experience Ann. Thorac. Surg., December 1, 2007; 84(6): 2070 - 2075. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Januszewska, A. Stebel, and E. Malec Consequences of Right Ventricle to Pulmonary Artery Shunt at the First Stage for the Fontan Operation Ann. Thorac. Surg., November 1, 2007; 84(5): 1611 - 1617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Ballweg, T. E. Dominguez, C. Ravishankar, J. Kreutzer, B. S. Marino, G. L. Bird, P. J. Gruber, G. Wernovsky, J. W. Gaynor, S. C. Nicolson, et al. A contemporary comparison of the effect of shunt type in hypoplastic left heart syndrome on the hemodynamics and outcome at stage 2 reconstruction J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 297 - 303. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Lai, P. C. Laussen, C. L. Cua, D. L. Wessel, J. M. Costello, P. J. del Nido, J. E. Mayer, and R. R. Thiagarajan Outcomes After Bidirectional Glenn Operation: Blalock-Taussig Shunt Versus Right Ventricle-to-Pulmonary Artery Conduit Ann. Thorac. Surg., May 1, 2007; 83(5): 1768 - 1773. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Edwards, K. P Morris, A. Siddiqui, D. Harrington, D. Barron, and W. Brawn Norwood procedure for hypoplastic left heart syndrome: BT shunt or RV-PA conduit? Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F210 - F214. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Sano New Era in Management of Hypoplastic Left Heart Syndrome Asian Cardiovasc Thorac Ann, April 1, 2007; 15(2): 83 - 85. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Griselli, S. P. McGuirk, V. Ofoe, O. Stumper, J. G.C. Wright, J. V. de Giovanni, D. J. Barron, and W. J. Brawn Fate of pulmonary arteries following Norwood Procedure Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 930 - 935. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Dave and R. Pretre Simple Technique to Quickly Access a RV-PA Shunt During the Second Stage of the Norwood-Fontan Pathway. Ann. Thorac. Surg., March 1, 2006; 81(3): 1148 - 1149. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S P McGuirk, M Griselli, O F Stumper, E M Rumball, P Miller, R Dhillon, J V de Giovanni, J G Wright, D J Barron, and W J Brawn Staged surgical management of hypoplastic left heart syndrome: a single institution 12 year experience Heart, March 1, 2006; 92(3): 364 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Griselli, S. P. McGuirk, O. Stumper, A. J.B. Clarke, P. Miller, R. Dhillon, J. G.C. Wright, J. V. de Giovanni, D. J. Barron, and W. J. Brawn Influence of surgical strategies on outcome after the Norwood procedure J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 418 - 426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Tabbutt, T. E. Dominguez, C. Ravishankar, B. S. Marino, P. J. Gruber, G. Wernovsky, J. W. Gaynor, S. C. Nicolson, and T. L. Spray Outcomes After the Stage I Reconstruction Comparing the Right Ventricular to Pulmonary Artery Conduit With the Modified Blalock Taussig Shunt Ann. Thorac. Surg., November 1, 2005; 80(5): 1582 - 1591. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Cua, R. R. Thiagarajan, R. Taeed, T. M. Hoffman, L. Lai, J. Hayes, P. C. Laussen, and T. F. Feltes Improved Interstage Mortality With the Modified Norwood Procedure: A Meta-Analysis Ann. Thorac. Surg., July 1, 2005; 80(1): 44 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Januszewska, J. Kolcz, T. Mroczek, M. Procelewska, and E. Malec Right ventricle-to-pulmonary artery shunt and modified Blalock-Taussig shunt in preparation to hemi-Fontan procedure in children with hypoplastic left heart syndrome Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 956 - 961. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Rumball, S. P. McGuirk, O. Stumper, S. J. Laker, J. V. de Giovanni, J. G. Wright, D. J. Barron, and W. J. Brawn The RV-PA conduit stimulates better growth of the pulmonary arteries in hypoplastic left heart syndrome Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 801 - 806. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U Theilen and L Shekerdemian The intensive care of infants with hypoplastic left heart syndrome Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2005; 90(2): F97 - F102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Bradley, J. M. Simsic, T. C. McQuinn, D. M. Habib, G. S. Shirali, and A. M. Atz Hemodynamic status after the Norwood procedure: A comparison of right ventricle-to-pulmonary artery connection versus modified blalock-taussig shunt Ann. Thorac. Surg., September 1, 2004; 78(3): 933 - 941. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
