PMID: 8604931Dec 1, 1995Paper

Avoidance of subaortic obstruction in staged management of single ventricle

The Annals of Thoracic Surgery
Marshall L JacobsW I Norwood

Abstract

Subaortic obstruction is a frequent accompaniment of single-ventricle anatomy. Most often, the aorta arises from an outflow chamber that is connected to the single ventricle by a bulboventricular foramen or ventricular septal defect. This connection may be restrictive of flow at birth, or may become obstructive after surgical procedures that reduce the volume work of the ventricle. Subaortic obstruction is recognized as a risk factor for reconstructive surgical procedures for single ventricle. To prevent the consequences of subaortic obstruction, we have routinely amalgamated the proximal main pulmonary artery with the ascending aorta and arch early in the management of these patients. From September 1990 through September 1994, 29 neonates and infants with single ventricle and established or potential subaortic obstruction underwent staged reconstructive surgical procedures. The initial operation in the newborn period was a Norwood procedure (18 patients) or a pulmonary artery band (5 patients). All survivors underwent a hemi-Fontan procedure at approximately 6 months. Eighteen patients have undergone a completion Fontan operation with no deaths. Five await completion Fontan. None has subaortic obstruction, and none has pulmon...Continue Reading

References

Dec 11, 1992·The Annals of Thoracic Surgery·W I NorwoodJ D Murphy
Sep 1, 1991·The Annals of Thoracic Surgery·T R KarlR B Mee
Sep 11, 1991·The Annals of Thoracic Surgery·W I Norwood
Oct 1, 1994·The Annals of Thoracic Surgery·M L Jacobs, W I Norwood

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Citations

Nov 22, 2005·Cardiology in the Young·Sylvie BertrandMarc R de Leval
Jan 13, 2006·Cardiology in the Young·Marshall L Jacobs, Glenn Pelletier
Jan 13, 2004·Journal of the American College of Cardiology·Yueh-Tze LanHillel Laks

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