Outcome of right ventricle-to-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome: a multi-institutional study

The Annals of Thoracic Surgery
Shunji SanoMasaaki Kawada


To evaluate the developing surgical technique of a modified Norwood procedure using a right ventricle-to-pulmonary artery shunt, we analyzed data obtained from 73 infants who underwent first-stage palliation for hypoplastic left heart syndrome between 1998 to 2002 at three centers in Japan. Procedures performed included an aortopulmonary neoaortic reconstruction and a nonvalved polytetrafluoroethylene shunt between a small right ventriculotomy and a distal stump of the main pulmonary artery. The size of the shunt used was 4 mm in 6 patients, 5 mm in 41, and 6 mm in 26. Continuous cerebral perfusion was used in all patients and an additional descending aortic perfusion was used in 39. Postoperative management was basically the same as that for infants undergoing other types of operations. There were 61 hospital survivors (84%), including 5 of 6 patients weighing less than 2 kg, with 8 late deaths. Risk factors for hospital mortality include preoperative treatment without ventilatory support and surgeon's experience (first 10 cases). Three patients underwent a primary Fontan operation at 5, 9, and 10 months of age, with one late death. Forty-one patients underwent the bidirectional Glenn shunt after a mean interval of 6.9 months,...Continue Reading


Jul 11, 1992·The Annals of Thoracic Surgery·D R JobesWilliam I Norwood
Oct 9, 1986·The New England Journal of Medicine·L L BaileyE L Petry
Aug 1, 1995·The Annals of Thoracic Surgery·S BrannN Sreeram
Sep 1, 1996·Annals of Surgery·Edward L Bove, T R Lloyd
Jul 15, 1997·The American Journal of Cardiology·J H KernJ M Quaegebeur
Dec 14, 1999·The Journal of Thoracic and Cardiovascular Surgery·H KishimotoT Mori
Nov 2, 2001·The Journal of Thoracic and Cardiovascular Surgery·Y ImotoH Yasui
Jan 16, 2002·The Annals of Thoracic Surgery·Scott M BradleyAndrew M Atz
Apr 5, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Christian PizarroWilliam I Norwood
Jul 10, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·J William GaynorThomas L Spray


Jan 29, 2010·Pediatric Radiology·Jonathan R DillmanRamiro J Hernandez
May 7, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Tomasz MroczekJanusz Skalski
Jul 5, 2003·The Annals of Thoracic Surgery·Kathleen N FentonFrank A Pigula
Mar 6, 2004·Seminars in Neonatology : SN·Caren S Goldberg, Carlen A Gomez
May 28, 2010·The New England Journal of Medicine·Richard G OhyePediatric Heart Network Investigators
Jun 21, 2013·The New England Journal of Medicine·David L WesselCLARINET Investigators
Feb 22, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Koichi SughimotoMasanao Ohba
Jul 11, 2006·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·David Michael McMullan, Heidi J Dalton
Jul 8, 2008·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·D Scott LimChristopher M Kramer
Apr 1, 2008·Radiology·Ana Maria GacaGeorge S Bisset
Jun 17, 2011·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·S O AlgraF Haas
Dec 18, 2013·The Journal of Thoracic and Cardiovascular Surgery·Ranjit AiyagariPediatric Heart Network Investigators
Jul 23, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Masataka KitanoKoji Kagisaki
Aug 21, 2012·The Journal of Thoracic and Cardiovascular Surgery·Richard G OhyePediatric Heart Network Investigators
May 29, 2012·The American Journal of Cardiology·Shaji C MenonLloyd Y Tani
Jul 10, 2012·The Journal of Thoracic and Cardiovascular Surgery·Ryo Aeba, Ryohei Yozu
Oct 26, 2010·The Annals of Thoracic Surgery·Shyam K SathanandamMichel N Ilbawi
May 8, 2010·The Journal of Thoracic and Cardiovascular Surgery·Satish K RajagopalEmile A Bacha
Feb 4, 2010·The Journal of Thoracic and Cardiovascular Surgery·Prem S VenugopalShakeel A Qureshi
May 24, 2008·The Annals of Thoracic Surgery·Jenifer A GlatzJames S Tweddell
Oct 24, 2007·The Annals of Thoracic Surgery·Shunji Sano
Jul 31, 2004·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Shunji SanoOsami Honjo
Sep 11, 2007·Seminars in Fetal & Neonatal Medicine·Hikoro Matsui, Helena Gardiner
Dec 11, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Benjamin PietersChrister Jonmarker
May 26, 2010·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·Jack RychikM P Johnson
Jan 10, 2006·The Journal of Thoracic and Cardiovascular Surgery·Emile A BachaZiyad M Hijazi
Oct 26, 2005·Seminars in Fetal & Neonatal Medicine·Jack Rychik
Jul 9, 2010·The Annals of Thoracic Surgery·Eric M GrahamAndrew M Atz

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