Literature DB >> 16474256

Early postoperative outcomes in a series of infants with hypoplastic left heart syndrome undergoing stage I palliation operation with either modified Blalock-Taussig shunt or right ventricle to pulmonary artery conduit.

Clifford L Cua1, Ravi R Thiagarajan, Kimberlee Gauvreau, Lillian Lai, John M Costello, David L Wessel, Pedro J Del Nido, John E Mayer, Jane W Newburger, Peter C Laussen.   

Abstract

OBJECTIVE: Previous publications using nonconcurrent series of patients indicate improved survival for patients with hypoplastic left heart syndrome (HLHS) undergoing stage I palliation with a right ventricle to pulmonary artery conduit (NW-RVPA) vs. a modified Blalock-Taussig shunt (NW-BT). We compared postoperative outcomes in a concurrent series of patients with HLHS undergoing an NW-BT procedure vs. NW-RVPA procedure.
DESIGN: Perioperative data from 66 consecutive patients who underwent NW-BT (n = 37) or NW-RVPA (n = 29) procedures were retrospectively analyzed.
SETTING: Cardiac intensive care unit in a tertiary pediatric hospital. PATIENTS: Charts were reviewed for all patients with the diagnosis of HLHS undergoing the NW-BT or NW-RVPA procedure between January 2002 and December 2003.
RESULTS: Cardiopulmonary bypass time was longer in the NW-BT group than in the NW-RVPA group (152.5 +/- 52.0 vs. 134.5 +/- 36.1 mins; p = .04). Postoperative diastolic pressures were higher and the Pao2 to Fio2 ratio profiles were lower for the NW-RVPA group over the first 72 hrs. Time to sternal closure (2 [1-6] vs. 4 [2-41] days; p = .01), duration of mechanical ventilation (113 [49-386] vs. 136 [84-764] hrs; p = .01), time to establish enteral feeds (4 [2-8] vs. 5 [3-22] days; p = .01), length of intensive care unit stay (11 [7-55] vs. 15 [8-90] days; p = .04), and length of hospital stay (16 [11-67] vs. 27 [12-126] days; p = .01) were shorter in the NW-RVPA group. Postoperative mortality was not significantly different between the NW-RVPA group (7%) and NW-BT group (11%).
CONCLUSION: At an experienced institution with low stage I palliation mortality for HLHS, there were no differences in early morbidity and mortality between the NW-RVPA and NW-BT procedures. The primary advantage of the NW-RVPA procedure may be faster recovery following surgery and earlier discharge from the hospital.

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Year:  2006        PMID: 16474256     DOI: 10.1097/01.PCC.0000201003.38320.63

Source DB:  PubMed          Journal:  Pediatr Crit Care Med        ISSN: 1529-7535            Impact factor:   3.624


  24 in total

1.  Comparison of shunt types in the Norwood procedure for single-ventricle lesions.

Authors:  Richard G Ohye; Lynn A Sleeper; Lynn Mahony; Jane W Newburger; Gail D Pearson; Minmin Lu; Caren S Goldberg; Sarah Tabbutt; Peter C Frommelt; Nancy S Ghanayem; Peter C Laussen; John F Rhodes; Alan B Lewis; Seema Mital; Chitra Ravishankar; Ismee A Williams; Carolyn Dunbar-Masterson; Andrew M Atz; Steven Colan; L LuAnn Minich; Christian Pizarro; Kirk R Kanter; James Jaggers; Jeffrey P Jacobs; Catherine Dent Krawczeski; Nancy Pike; Brian W McCrindle; Lisa Virzi; J William Gaynor
Journal:  N Engl J Med       Date:  2010-05-27       Impact factor: 91.245

2.  Validation of a Simple Score to Determine Risk of Hospital Mortality After the Norwood Procedure.

Authors:  Shahryar M Chowdhury; Eric M Graham; Andrew M Atz; Scott M Bradley; Minoo N Kavarana; Ryan J Butts
Journal:  Semin Thorac Cardiovasc Surg       Date:  2016-04-19

3.  Perioperative care of the infant with single ventricle physiology.

Authors:  Vamsi V Yarlagadda; Melvin C Almodovar
Journal:  Curr Treat Options Cardiovasc Med       Date:  2011-10

4.  Results of a Feeding Protocol in Patients Undergoing the Hybrid Procedure.

Authors:  Kirby-Rose Carpenito; Regina Prusinski; Kristin Kirchner; Janet Simsic; Yongjie Miao; Wendy Luce; John P Cheatham; Mark Galantowicz; Carl H Backes; Clifford L Cua
Journal:  Pediatr Cardiol       Date:  2016-02-26       Impact factor: 1.655

5.  Intermediate-term mortality and cardiac transplantation in infants with single-ventricle lesions: risk factors and their interaction with shunt type.

Authors:  James S Tweddell; Lynn A Sleeper; Richard G Ohye; Ismee A Williams; Lynn Mahony; Christian Pizarro; Victoria L Pemberton; Peter C Frommelt; Scott M Bradley; James F Cnota; Jennifer Hirsch; Paul M Kirshbom; Jennifer S Li; Nancy Pike; Michael Puchalski; Chitra Ravishankar; Jeffrey P Jacobs; Peter C Laussen; Brian W McCrindle
Journal:  J Thorac Cardiovasc Surg       Date:  2012-02-15       Impact factor: 5.209

6.  Risk factors for hospital morbidity and mortality after the Norwood procedure: A report from the Pediatric Heart Network Single Ventricle Reconstruction trial.

Authors:  Sarah Tabbutt; Nancy Ghanayem; Chitra Ravishankar; Lynn A Sleeper; David S Cooper; Deborah U Frank; Minmin Lu; Christian Pizarro; Peter Frommelt; Caren S Goldberg; Eric M Graham; Catherine Dent Krawczeski; Wyman W Lai; Alan Lewis; Joel A Kirsh; Lynn Mahony; Richard G Ohye; Janet Simsic; Andrew J Lodge; Ellen Spurrier; Mario Stylianou; Peter Laussen
Journal:  J Thorac Cardiovasc Surg       Date:  2012-06-15       Impact factor: 5.209

7.  Choices doctors would make if their infant had hypoplastic left heart syndrome: comparison of survey data from 1999 and 2007.

Authors:  Alexander A Kon; Milan Prsa; Charles V Rohlicek
Journal:  Pediatr Cardiol       Date:  2012-08-15       Impact factor: 1.655

8.  Design and rationale of a randomized trial comparing the Blalock-Taussig and right ventricle-pulmonary artery shunts in the Norwood procedure.

Authors:  Richard G Ohye; J William Gaynor; Nancy S Ghanayem; Caren S Goldberg; Peter C Laussen; Peter C Frommelt; Jane W Newburger; Gail D Pearson; Sarah Tabbutt; Gil Wernovsky; Lisa M Wruck; Andrew M Atz; Steve D Colan; James Jaggers; Brian W McCrindle; Ashwin Prakash; Michael D Puchalski; Lynn A Sleeper; Mario P Stylianou; Lynn Mahony
Journal:  J Thorac Cardiovasc Surg       Date:  2008-05-19       Impact factor: 5.209

9.  Cause, timing, and location of death in the Single Ventricle Reconstruction trial.

Authors:  Richard G Ohye; Julie V Schonbeck; Pirooz Eghtesady; Peter C Laussen; Christian Pizarro; Peter Shrader; Deborah U Frank; Eric M Graham; Kevin D Hill; Jeffrey P Jacobs; Kirk R Kanter; Joel A Kirsh; Linda M Lambert; Alan B Lewis; Chitra Ravishankar; James S Tweddell; Ismee A Williams; Gail D Pearson
Journal:  J Thorac Cardiovasc Surg       Date:  2012-08-15       Impact factor: 5.209

10.  Frequency and indications for tracheostomy and gastrostomy after congenital heart surgery.

Authors:  Anthony F Rossi; Steven Fishberger; Robert L Hannan; Jo Ann Nieves; Juan Bolivar; Nancy Dobrolet; Redmond P Burke
Journal:  Pediatr Cardiol       Date:  2008-11-15       Impact factor: 1.655

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