The effect of morphologic subtype on outcomes following the Sano-Norwood procedure

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Bari MurtuzaWilliam Brawn

Abstract

Controversy exists concerning outcomes of patients with different morphologic subtypes of hypoplastic left heart syndrome undergoing the Norwood procedure, in particular, aortic atresia-mitral stenosis (AA-MS) patients receiving a systemic-pulmonary modified Blalock-Taussig (mBT) shunt. We sought to determine the influence of known risk factors and morphology on early survival in our cohort of Sano-Norwood patients with right ventricle-pulmonary artery (RV-PA) conduits as the source of pulmonary blood flow. We studied early survival in patients with Sano-modified Norwood procedures from 2002 to 2010 and included both typical and atypical (including unbalanced atrioventricular canal defect) morphologic variants. We included a comparison group composed of classical Norwood patients with mBT shunts. Of 264 Sano-Norwood patients, 49 had AA-MS and 30 had atypical morphologies. Weight ≤ 2.5 kg was associated with a poorer 1-year survival (P = 0.0007), though ascending aorta (AscAo) size <2.0 mm was not. We did not observe a difference in 30-day or 1-year Kaplan-Meier (K-M) survival across typical morphologic variants for either a Sano or mBTS group. Atypical variants exhibited a trend towards lower 30-day and 1-year survival in both ...Continue Reading

References

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Aug 25, 2009·The Journal of Thoracic and Cardiovascular Surgery·David J BarronWilliam J Brawn
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May 28, 2010·The New England Journal of Medicine·Richard G OhyeUNKNOWN Pediatric Heart Network Investigators
Dec 7, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Gencheng ZhangJia Li
Feb 8, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Katarzyna JanuszewskaEdward Malec
Apr 1, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bari MurtuzaWilliam J Brawn

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Citations

Feb 14, 2017·The Journal of Thoracic and Cardiovascular Surgery·David J BarronWilliam J Brawn
May 10, 2013·Seminars in Cardiothoracic and Vascular Anesthesia·Michael ShillingfordMark Bleiweis
Oct 27, 2020·Pediatric Cardiology·Alan P WangUNKNOWN Wanek Family Program for Hypoplastic Left Heart Syndrome Imaging Pipeline

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