BACKGROUND: The Norwood procedure is the first stage palliative procedure for hypoplastic left heart syndrome (HLHS). Traditionally the pulmonary circulation has been supplied via a modified Blalock Taussig (BT) shunt but a recent modification, adopted in some UK centres, substitutes a conduit between right ventricle and pulmonary arteries (RV-PA conduit). It is argued that this will result in a more favourable balance between pulmonary and systemic circulations. AIM: To compare the early postoperative haemodynamic profile between patients undergoing a BT shunt or an RV-PA conduit. METHODS: Retrospective review in a tertiary referral PICU of 51 children with HLHS undergoing the Norwood procedure with either a BT shunt (Group 1; n = 23) or an RV-PA conduit (Group 2; n = 28). Data items were extracted at 10 set time points in the initial 96 h, postoperatively. RESULTS: Diastolic BP was significantly lower in Group 1 (p<0.001) with a trend towards a higher systolic BP and no difference in mean BP. No between-group differences were found in markers of pulmonary blood flow (PaO2, PaCO2, PaO2/FiO2 ratio), or in markers of systemic blood flow (blood lactate, oxygen extraction ratio), or in estimated ratio of pulmonary:systemic blood flow (Qp:Qs). Despite lower diastolic blood pressure in Group 1 renal and hepatic function did not differ over five post-operative days between groups. CONCLUSIONS: With the exception of a higher diastolic blood pressure in the RV-PA conduit group, we found no difference in the early haemodynamic profile between patients undergoing an RV-PA conduit or a BT shunt.
BACKGROUND: The Norwood procedure is the first stage palliative procedure for hypoplastic left heart syndrome (HLHS). Traditionally the pulmonary circulation has been supplied via a modified Blalock Taussig (BT) shunt but a recent modification, adopted in some UK centres, substitutes a conduit between right ventricle and pulmonary arteries (RV-PA conduit). It is argued that this will result in a more favourable balance between pulmonary and systemic circulations. AIM: To compare the early postoperative haemodynamic profile between patients undergoing a BT shunt or an RV-PA conduit. METHODS: Retrospective review in a tertiary referral PICU of 51 children with HLHS undergoing the Norwood procedure with either a BT shunt (Group 1; n = 23) or an RV-PA conduit (Group 2; n = 28). Data items were extracted at 10 set time points in the initial 96 h, postoperatively. RESULTS: Diastolic BP was significantly lower in Group 1 (p<0.001) with a trend towards a higher systolic BP and no difference in mean BP. No between-group differences were found in markers of pulmonary blood flow (PaO2, PaCO2, PaO2/FiO2 ratio), or in markers of systemic blood flow (blood lactate, oxygen extraction ratio), or in estimated ratio of pulmonary:systemic blood flow (Qp:Qs). Despite lower diastolic blood pressure in Group 1 renal and hepatic function did not differ over five post-operative days between groups. CONCLUSIONS: With the exception of a higher diastolic blood pressure in the RV-PA conduit group, we found no difference in the early haemodynamic profile between patients undergoing an RV-PA conduit or a BT shunt.
Authors: G M Hoffman; N S Ghanayem; J M Kampine; S Berger; K A Mussatto; S B Litwin; J S Tweddell Journal: Ann Thorac Surg Date: 2000-11 Impact factor: 4.330
Authors: S Tabbutt; C Ramamoorthy; L M Montenegro; S M Durning; C D Kurth; J M Steven; R I Godinez; T L Spray; G Wernovsky; S C Nicolson Journal: Circulation Date: 2001-09-18 Impact factor: 29.690
Authors: Timothy M Hoffman; Gil Wernovsky; Andrew M Atz; James M Bailey; Akbar Akbary; John F Kocsis; David P Nelson; Anthony C Chang; Thomas J Kulik; Thomas L Spray; David L Wessel Journal: Am Heart J Date: 2002-01 Impact factor: 4.749
Authors: Christian Pizarro; Edward Malec; Kevin O Maher; Katarzyna Januszewska; Samuel S Gidding; Kenneth A Murdison; Jeanne M Baffa; William I Norwood Journal: Circulation Date: 2003-09-09 Impact factor: 29.690
Authors: T Azakie; S L Merklinger; B W McCrindle; G S Van Arsdell; K J Lee; L N Benson; J G Coles; W G Williams Journal: Ann Thorac Surg Date: 2001-10 Impact factor: 4.330
Authors: Rudolf Mair; Gerald Tulzer; Eva Sames; Roland Gitter; Evelyn Lechner; Jürgen Steiner; Anna Hofer; Gertraud Geiselseder; Christoph Gross Journal: J Thorac Cardiovasc Surg Date: 2003-11 Impact factor: 5.209
Authors: Kevin O Maher; Christian Pizarro; Samuel S Gidding; Katarzyna Januszewska; Edward Malec; William I Norwood; John D Murphy Journal: Circulation Date: 2003-08-11 Impact factor: 29.690
Authors: Jeffrey A Feinstein; D Woodrow Benson; Anne M Dubin; Meryl S Cohen; Dawn M Maxey; William T Mahle; Elfriede Pahl; Juan Villafañe; Ami B Bhatt; Lynn F Peng; Beth Ann Johnson; Alison L Marsden; Curt J Daniels; Nancy A Rudd; Christopher A Caldarone; Kathleen A Mussatto; David L Morales; D Dunbar Ivy; J William Gaynor; James S Tweddell; Barbara J Deal; Anke K Furck; Geoffrey L Rosenthal; Richard G Ohye; Nancy S Ghanayem; John P Cheatham; Wayne Tworetzky; Gerard R Martin Journal: J Am Coll Cardiol Date: 2012-01-03 Impact factor: 24.094