Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome.

This article reviews our experience using a prosthetic conduit between the right ventricle (RV) and the pulmonary artery (PA), in lieu of the more traditional aortopulmonary shunt, for infants undergoing surgical palliation of hypoplastic left heart syndrome. Thirty-three consecutive infants underwent Norwood procedure between February 1998 and November 2003, using an RV-PA conduit. There were 31 hospital survivors (94%) and 25 patients have undergone a stage II bidirectional Glenn anastomosis with an additional two deaths. Nine patients have undergone completion Fontan. This technique provides reproducible results, simplifies postoperative management, and improves outcome, especially for "low volume" programs.