Does the shunt type determine mid-term outcome after Norwood operation?

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Joachim PhotiadisViktor Hraška

Abstract

With improved short-term outcomes the right ventricular to pulmonary artery shunt (Sano) has become the preferred pulmonary blood source in the Norwood procedure in many centres. However, most studies analysed consecutive cohorts, with a first modified Blalock-Taussig shunt (BT) followed by the Sano cohort. Besides, neither comprehensive preoperative risk analysis nor outcome beyond 1 year of age was investigated. This study reviews 109 neonates undergoing the Norwood procedure in the same interval between October 2002 and December 2009. The Sano (38) or BT shunt (71) was assigned according to the surgeon's preference. Two neonates subsequently underwent successful biventricular repair and were excluded. The Aristotle comprehensive score (ACS) was used to evaluate preoperative risk, with high-risk patients (n = 39) classified as having an ACS ≥ 20, and low-risk patients (n = 68) given an ACS <20. Mean Aristotle score at the Norwood operation was 18.8 ± 0.4 and 18.9 ± 0.3 (P = 0.9) in Sano and BT, respectively. Mean follow-up interval was 4.1 ± 2.1 years (range: 1.7-8.9 years). Actuarial survival was similar, stabilizing from the 8th postoperative month onwards at 78.6 ± 4.9% (95% CI: 67.0-86.5%) for Sano and 78.4 ± 6.8% (95% CI...Continue Reading

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Citations

Jun 5, 2012·Pediatric Cardiology·Julia FischbachJoachim Photiadis
Jul 19, 2013·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Brian C H Gulack, Obinna O Adibe
Mar 9, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Andrea MünstererChristian Schreiber
May 6, 2014·The Annals of Thoracic Surgery·Vikas SharmaHarold M Burkhart
Apr 2, 2014·The Journal of Thoracic and Cardiovascular Surgery·Alexander A BresciaCharles B Huddleston
Apr 8, 2014·Circulation·Jane W NewburgerUNKNOWN Pediatric Heart Network Investigators
Jul 1, 2018·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Smruti Ranjan Mohanty
May 30, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Masamichi OnoJürgen Hörer

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