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A Comparison of the Modified Blalock-Taussig Shunt With the Right Ventricle-to-Pulmonary Artery Conduit.
MedLine Citation:
PMID:  21524459     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: This study compared the modified Blalock-Taussig (MBT) shunt with the right ventricle-to-pulmonary artery (RVPA) conduit with respect to outcome and PA growth.
METHODS: PA growth was assessed in 19 MBT patients and in 15 RVPA patients before stage 2 palliation for hypoplastic left heart syndrome. The RVPA was done with a ringed Gore-Tex tube (W. L. Gore and Assoc, Flagstaff, AZ) at each anastomosis.
RESULTS: The two cohorts had similar pre-Glenn demographic and hemodynamic data. No patient required transcatheter or surgical intervention on the shunt or PAs after stage 1 palliation. The branch PA growth was better in RVPA (McGoon ratio: MBT, 1.5 ± 0.2 vs RVPA, 2.0 ± 0.6; p < 0.003) and was significantly more balanced (right-to-left PA area ratio: MBT, 1.5 ± 0.5 vs RVPA, 0.9 ± 0.6; p = 0.002). The Nakata index trended higher in RVPA (MBT, 242A ± 90 mm(2)/m(2) vs RVPA, 267 ± 95 mm(2)/m(2), p = 0.2). After stage 2 palliation, oxygen saturation trended higher in the RVPA (81% ± 5%) vs MBT cohort (77% ± 8%, p < 0.08).
CONCLUSIONS: The Norwood operation using a RVPA nonvalved conduit is associated with improved branch PA growth.
Authors:
Andrew C Fiore; Courtney Tobin; Saadeh Jureidini; Mohammad Rahimi; Eric S Kim; Kenneth Schowengerdt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  91     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1479-85     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Pediatric Cardiac Surgery, Cardinal Glennon Children's Hospital, St. Louis University School of Medicine, St. Louis, Missouri.
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