Comparison of Shunt Types in the Norwood Procedure for Single-Ventricle Lesions

Hypoplastic left heart syndrome is a complex congenital heart lesion that requires a three-stage procedure for surgical palliation. This clinical trial examines two approaches to the first stage of the procedure, and the results provide important guidance for the most appropriate surgical management...

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Vydáno v:The New England journal of medicine Ročník 362; číslo 21; s. 1980 - 1992
Hlavní autoři: Ohye, Richard G, Sleeper, Lynn A, Mahony, Lynn, Newburger, Jane W, Pearson, Gail D, Lu, Minmin, Goldberg, Caren S, Tabbutt, Sarah, Frommelt, Peter C, Ghanayem, Nancy S, Laussen, Peter C, Rhodes, John F, Lewis, Alan B, Mital, Seema, Ravishankar, Chitra, Williams, Ismee A, Dunbar-Masterson, Carolyn, Atz, Andrew M, Colan, Steven, Minich, L. LuAnn, Pizarro, Christian, Kanter, Kirk R, Jaggers, James, Jacobs, Jeffrey P, Krawczeski, Catherine Dent, Pike, Nancy, McCrindle, Brian W, Virzi, Lisa, Gaynor, J. William
Médium: Journal Article
Jazyk:angličtina
Vydáno: Waltham, MA Massachusetts Medical Society 27.05.2010
Témata:
Biological and medical sciences
Cardiac Surgical Procedures - methods
Cardiology. Vascular system
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Female
Follow-Up Studies
General aspects
Heart
Heart Bypass, Right - methods
Heart Transplantation - statistics & numerical data
Heart Ventricles - abnormalities
Heart Ventricles - surgery
Humans
Hypoplastic Left Heart Syndrome - mortality
Hypoplastic Left Heart Syndrome - surgery
Infant, Newborn
Intention to Treat Analysis
Kaplan-Meier Estimate
Male
Medical sciences
Postoperative Complications
Proportional Hazards Models
Pulmonary arteries
Pulmonary Artery - surgery
Veins & arteries
Medicine
Methodology
Shunt
Heart disease
Cardiovascular disease
Procedure
Single ventricle
Lesion
Congenital disease
Comparative study
ISSN:0028-4793, 1533-4406, 1533-4406
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Popis
Shrnutí:Hypoplastic left heart syndrome is a complex congenital heart lesion that requires a three-stage procedure for surgical palliation. This clinical trial examines two approaches to the first stage of the procedure, and the results provide important guidance for the most appropriate surgical management of this serious lesion. This clinical trial examines two approaches to the first stage of the Norwood procedure, and the results provide important guidance for the most appropriate surgical management of this serious lesion. Hypoplastic left heart syndrome and related anomalies involving a single right ventricle are characterized by hypoplasia of the left heart and the aorta, with compromised systemic cardiac output (Figure 1). Infants with the syndrome generally undergo a three-stage reconstruction culminating in the Fontan procedure. The first operation (stage I) is the Norwood procedure, in which the right ventricle is connected to a reconstructed aorta with the use of the proximal main pulmonary artery for systemic outflow. Pulmonary blood flow is reestablished by means of a shunt from the pulmonary artery to the systemic circulation. In the second operation (stage II), . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa0912461