Efficacy of the Norwood Operation with a Right Ventricle-Pulmonary Artery Shunt at 1 Month after Bilateral Pulmonary Artery Banding

Sanae Yamauchi, Hiroaki Kawata, Shigemitsu Iwai, Motoki Komori, Yuji Tominaga, Futoshi Kayatani, Noboru Inamura, Hidefumi Kishimoto
2015 Pediatric Cardiology and Cardiac Surgery  
Objective: Between 2004 and 2011 in our institution, we performed the Norwood operation (NW) with bidirectional Glenn shunt (BDG) for patients with hypoplastic le heart syndrome (HLHS) at 3 months old following bilateral pulmonary artery banding (BPAB). Since 2012, we have been performsaing NW with a right ventricular-pulmonary shunt (RV PA shunt) 1 month a er BPAB in HLHS patients. e aim of this study was to evaluate the e cacy of a rapid two-stage NW operation. Methods: Between January 2004
more » ... ween January 2004 and December 2013, a total of 28 HLHS patients underwent NW. NW with BDG was performed in 22 patients (Group G) and NW with an RV PA shunt was performed in 6 patients (Group S). Surgical results were compared between the groups. Results: In Group G, 8 patients (36.3 ) required pulmonary artery plasty and 20 patients (91.0 ) underwent catheter intervention for pulmonary artery (PTPA). Postoperative complications comprised 3 in-hospital deaths, 2 BDG take-downs, and 1 cerebrovascular infarction. In Group S, no patients required either pulmonary artery plasty or PTPA, and BDG was performed at a median age of 7 months (range, 6 13 months). Postoperative pressure in the superior vena cava (SVC) was signi cantly lower in Group S. Conclusions: NW with an RV PA shunt 1 month a er BPAB enabled avoidance of PTPA and maintenance of a low SVC pressure following BDG, and was thought to improve surgical outcomes.
doi:10.9794/jspccs.31.102 fatcat:qrn5c3avdfawrol2svtfp24qqy