| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2004;78:1959-1964
© 2004 The Society of Thoracic Surgeons
Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware, and Polish-American Children Hospital, Krakow, Poland, USA
Accepted for publication June 4, 2004.
* Address reprint requests to Dr Pizarro, 1600 Rockland Rd, PO Box 269, Wilmington, DE19899 (E-mail: cpizarro{at}nemours.org).
Presented at the Fortieth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 26–28, 2004.
BACKGROUND: Despite significant improvement in survival after stage 1 Norwood, interim mortality before the second-stage operation remains significant. On the basis of reports of improved circulatory stability associated with the use of a right ventricle to pulmonary artery conduit, the difference between two physiologically different sources of pulmonary blood flow on interim mortality was investigated.
METHODS: Data collection of 96 consecutive hospital survivors after stage 1 Norwood surgery was undertaken. The source of pulmonary blood flow was a modified right Blalock-Taussig shunt in 46 (BTS) and a right ventricle to pulmonary artery conduit in 50 patients. The same follow-up protocol was used in both groups. Data analysis was performed to identify variables associated with interim mortality.
RESULTS: Analysis of patient-related and procedure-related variables revealed no differences in age, weight, diagnosis, presence of aortic atresia, lowest perioperative pH, duration of cardiopulmonary bypass, circulatory arrest, length of mechanical ventilation, or hospital stay at the time of stage 1 Norwood between groups. Respiratory rate and systolic blood pressure were the only differences detected between groups at the time of discharge. Interim mortality was higher in the Blalock-Taussig shunt group. Statistical analysis identified aortic atresia, a modified Blalock-Taussig shunt, and the presence of perioperative dysrhythmias to be associated with interim mortality.
CONCLUSIONS: The use of a right ventricle to pulmonary artery shunt decreases the incidence of interim mortality among hospital survivors after stage 1 Norwood for hypoplastic left heart syndrome. Aortic atresia, the use of a modified Blalock-Taussig shunt, and perioperative dysrhythmias are independently associated with a higher mortality before superior cavopulmonary connection.
This article has been cited by other articles:
|
|
 |
|
  J. Atallah, I. A. Dinu, A. R. Joffe, C. M.T. Robertson, R. S. Sauve, J. D. Dyck, D. B. Ross, I. M. Rebeyka, and the Western Canadian Complex Pediatric Therapies F Two-Year Survival and Mental and Psychomotor Outcomes After the Norwood Procedure: An Analysis of the Modified Blalock-Taussig Shunt and Right Ventricle-to-Pulmonary Artery Shunt Surgical Eras Circulation, September 30, 2008; 118(14): 1410 - 1418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Scheurer, J. W. Salvin, V. L. Vida, F. Fynn-Thompson, E. A. Bacha, F. A. Pigula, J. E. Mayer Jr, P. J. del Nido, D. L. Wessel, P. C. Laussen, et al. Survival and clinical course at fontan after stage one palliation with either a modified blalock-taussig shunt or a right ventricle to pulmonary artery conduit. J. Am. Coll. Cardiol., July 1, 2008; 52(1): 52 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Hehir, T. E. Dominguez, J. A. Ballweg, C. Ravishankar, B. S. Marino, G. L. Bird, S. C. Nicolson, T. L. Spray, J. W. Gaynor, and S. Tabbutt Risk factors for interstage death after stage 1 reconstruction of hypoplastic left heart syndrome and variants J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 94 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Bradley, C. C. Erdem, T.-Y. Hsia, A. M. Atz, V. Bandisode, and J. M. Ringewald Right Ventricle-to-Pulmonary Artery Shunt: Alternative Palliation in Infants With Inadequate Pulmonary Blood Flow Prior to Two-Ventricle Repair. Ann. Thorac. Surg., July 1, 2008; 86(1): 183 - 188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S V Rasiah, A K Ewer, P Miller, J G Wright, D J Barron, W J Brawn, and M D Kilby Antenatal perspective of hypoplastic left heart syndrome: 5 years on Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2008; 93(3): F192 - F197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Pizarro, C. D. Derby, J. M. Baffa, K. A. Murdison, and W. A. Radtke Improving the outcome of high-risk neonates with hypoplastic left heart syndrome: hybrid procedure or conventional surgical palliation? Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 613 - 618. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Rodriguez, M. Al-Ahmadi, and T. L. Spray Surgical approach to hyploplastic left heart syndrome Norwood Stage I MMCTS, December 17, 2007; 2007(1217): 2733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
V. L. Vida, E. A. Bacha, A. Larrazabal, K. Gauvreau, R. Thiagaragan, F. Fynn-Thompson, F. A. Pigula, J. E. Mayer Jr, P. J. del Nido, W. Tworetzky, et al. Hypoplastic Left Heart Syndrome With Intact or Highly Restrictive Atrial Septum: Surgical Experience From a Single Center Ann. Thorac. Surg., August 1, 2007; 84(2): 581 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Delius Invited commentary Ann. Thorac. Surg., April 1, 2007; 83(4): 1436 - 1437. [Full Text] [PDF]
|
|
|
|
|
|
C. Schreiber, Z. Prodan, A. Eicken, and L. Rudiger Novel Modification of Right Ventricle to Pulmonary Artery Shunt in Palliation of Hypoplastic Left Heart Syndrome Ann. Thorac. Surg., March 1, 2007; 83(3): 1231 - 1231. [Full Text] [PDF]
|
|
|
|
 |
|
 B. Alsoufi, J. Bennetts, S. Verma, and C. A. Caldarone New Developments in the Treatment of Hypoplastic Left Heart Syndrome Pediatrics, January 1, 2007; 119(1): 109 - 117. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. S. Ghanayem, R. D.B. Jaquiss, J. R. Cava, P. C. Frommelt, K. A. Mussatto, G. M. Hoffman, and J. S. Tweddell Right Ventricle-to-Pulmonary Artery Conduit Versus Blalock-Taussig Shunt: A Hemodynamic Comparison Ann. Thorac. Surg., November 1, 2006; 82(5): 1603 - 1610. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ricci, P. Lombardi, A. Galindo, S. Schultz, A. Vasquez, and E. Rosenkranz Effects of single-ventricle physiology with aortopulmonary shunt on regional myocardial blood flow in a piglet model. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 252 - 259.e2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kats, P. L. de Jong, M. Witsenburg, and A. J.J.C. Bogers Massive haemorrhage at resternotomy after stent implantation in ventriculo-pulmonary shunt after Norwood procedure Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 234 - 235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Graham, G. A. Forbus, S. M. Bradley, G. S. Shirali, and A. M. Atz Incidence and outcome of cardiopulmonary resuscitation in patients with shunted single ventricle: Advantage of right ventricle to pulmonary artery shunt J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): e7 - e8. [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. L. Skinner, L. A. Halstead, C. S. Rubinstein, A. M. Atz, D. Andrews, and S. M. Bradley Laryngopharyngeal dysfunction after the Norwood procedure J. Thorac. Cardiovasc. Surg., November 1, 2005; 130(5): 1293 - 1301. [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 |
