دورية أكاديمية
Combined Norwood and cavopulmonary shunt as the first palliation in late presenters with hypoplastic left heart syndrome and single-ventricle lesions.
| العنوان: | Combined Norwood and cavopulmonary shunt as the first palliation in late presenters with hypoplastic left heart syndrome and single-ventricle lesions. |
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| المؤلفون: | Elmahrouk AF; Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt., Ismail MF; Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; Cardiothoracic Surgery Department, Mansoura University, Mansoura, Egypt., Arafat AA; Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt., Dohain AM; Cardiology Division, Department of Pediatrics, Cairo University, Cairo, Egypt; Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia., Edrees AM MBBS; Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Jamjoom AA MBBS, FRCSC; Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Al-Radi OO; Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; Division of Cardiac Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: oradi@kau.edu.sa. |
| المصدر: | The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2022 May; Vol. 163 (5), pp. 1592-1600. Date of Electronic Publication: 2021 Nov 29. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: St. Louis. |
| مواضيع طبية MeSH: | Heart Bypass, Right*/adverse effects , Hypoplastic Left Heart Syndrome*/surgery , Univentricular Heart*, Aftercare ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/surgery ; Humans ; Oxygen ; Palliative Care ; Patient Discharge ; Pulmonary Artery/surgery ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Objective: A primary cavopulmonary shunt as a component of the initial Norwood palliation could be an option in patients with hypoplastic left heart syndrome and single-ventricle lesions. We present our initial experience with this approach in carefully selected patients with unrestricted pulmonary blood flow and low pulmonary vascular resistance. Methods: The study included 16 patients; the mean age was 137.9 ± 84.2 days. All patients underwent a Norwood palliation consisting of atrial septectomy, Damus-Kaye-Stansel connection, and arch augmentation in addition to the cavopulmonary shunt as the initial palliation. Results: The mean preoperative pulmonary to systemic blood flow (Qp/Qs) ratio on room air (n = 9) and with 100% oxygen (n = 8) was 5.3 ± 3.2 and 8.6 ± 4.3, respectively. The mean pulmonary vascular resistance on room air (n = 10) and 100% oxygen (n = 9) was 4.8 ± 3.1 and 1.7 ± 0.97 WU/m 2 , respectively. Delayed chest closure was needed in 12 patients, and 6 patients required postoperative inhaled nitric oxide. One patient underwent takedown of the cavopulmonary shunt and construction of the right ventricle to pulmonary artery conduit after 1 month. The mean intensive care unit stay was 18.9 ± 15.4 days. There were 2 in-hospital deaths (48 hours and 8 days after surgery) and 2 postdischarge deaths (6 months and 2 years after hospital discharge). Seven patients have undergone the Fontan completion successfully, and 5 patients await further surgery. Conclusions: First-stage Norwood palliation with cavopulmonary shunt for patients with hypoplastic left heart syndrome or single-ventricle lesions is feasible in late presenters with low pulmonary vascular resistance. (Copyright © 2021 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: J Thorac Cardiovasc Surg. 2022 May;163(5):1602-1603. (PMID: 34895724) Comment in: J Thorac Cardiovasc Surg. 2022 May;163(5):1601-1602. (PMID: 34955282) |
| فهرسة مساهمة: | Keywords: Norwood; cavopulmonary shunt; hypoplastic left heart syndrome; late presentation; pulmonary vascular resistance |
| المشرفين على المادة: | S88TT14065 (Oxygen) |
| تواريخ الأحداث: | Date Created: 20220114 Date Completed: 20220418 Latest Revision: 20220503 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.jtcvs.2021.10.061 |
| PMID: | 35027212 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-685X |
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| DOI: | 10.1016/j.jtcvs.2021.10.061 |