Cardiovascular magnetic resonance of pulmonary artery growth and ventricular function after Norwood procedure with Sano modification

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
D Scott LimChristopher M Kramer

Abstract

For hypoplastic left heart syndrome (HLHS), there have been concerns regarding pulmonary artery growth and ventricular dysfunction after first stage surgery consisting of the Norwood procedure modified with a right ventricle-to-pulmonary artery conduit. We report our experience using cardiovascular magnetic resonance (CMR) to determine and follow pulmonary arterial growth and ventricular function in this cohort. Following first stage palliation, serial CMR was performed at 1 and 10 weeks post-operatively, followed by cardiac catheterization at 4-6 months. Thirty-four of 47 consecutive patients with HLHS (or its variations) underwent first stage palliation. Serial CMR was performed in 20 patients. Between studies, ejection fraction decreased (58 +/- 9% vs. 50 +/- 5%, p < 0.05). Pulmonary artery growth occurred on the left (6 +/- 1 mm vs. 4 +/- 1 mm at baseline, p < 0.05) but not significantly in the right. This trend continued to cardiac catheterization 4-6 months post surgery, with the left pulmonary artery of greater size than the right (8.8 +/- 2.2 mm vs. 6.7 +/- 1.9 mm, p < 0.05). By CMR, 5 had pulmonary artery stenoses initially, and at 2 months, 9 had stenoses. Three of the 9 underwent percutaneous intervention prior to th...Continue Reading

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Citations

Jan 29, 2010·Pediatric Radiology·Jonathan R DillmanRamiro J Hernandez
Feb 22, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Joachim PhotiadisViktor Hraska
Aug 20, 2014·The Annals of Thoracic Surgery·Shyam K SathanandamTarek S Husayni
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Aug 12, 2009·Archives of Cardiovascular Diseases·Shi-Min Yuan, Hua Jing
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