May 1, 1995

Surgery for infants with a hypoplastic systemic ventricle and severe outflow obstruction: early results with a modified Norwood procedure

British Heart Journal
F A Bu'LockW J Brawn

Abstract

Prospective audit of the first year of implementation of a modified approach to palliation for infants with hypoplastic systemic ventricle and severe systemic outflow obstruction. Tertiary referral centre for neonatal and infant cardiac surgery. 17 of 19 infants (aged < 35 days) presenting to Birmingham Children's Hospital in 1993 with hypoplastic systemic ventricle and severe outflow obstruction underwent surgery. This was performed using a new modification of the Norwood-type arch repair, without the use of exogenous material, and a 3.5 mm Gore-tex shunt between the innominate and right pulmonary arteries. The Gore-tex shunt was replaced by a cavopulmonary shunt between 3 and 5 months later. Clinical, morphological, and functional determinants of outcome were examined. 10 (59%) infants survived initial surgery. All proceeded to cavopulmonary shunt without further loss. Significant atrioventricular valve regurgitation seemed to be the main risk factor for poor outcome. If this was excluded, the morphology of the dominant ventricle seemed to have little effect on the outcome of initial surgery. Early survival was achieved in 59% of patients in the first year of implementation of a protocol for surgery in infants with hypoplasti...Continue Reading

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  • Citations28

Citations

Mentioned in this Paper

Cyanosis
Aplastic Anemia
Science of Morphology
Discipline of Heart Surgery
Pulmonary Artery Structure
Atrioventricular Valve
Obstruction
Ventricular Outflow Obstruction
Hypoplastic Left Heart Syndrome
Ventricle

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