Document Detail


Hemodynamic assessment after palliative surgery for hypoplastic left heart syndrome.
MedLine Citation:
PMID:  6189635     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ten patients with hypoplastic left heart syndrome underwent cardiac catheterization to assess the effectiveness of palliative surgery designed to prepare them for a modified Fontan procedure. The objectives of palliation were to establish unobstructed systemic blood flow, normalize pulmonary blood flow and pressure, and relieve pulmonary venous obstruction. In the first four patients, systemic blood flow from the right ventricle was established by means of a conduit from either the right ventricular free wall or the proximal main pulmonary artery to the thoracic aorta. Pulmonary blood flow was limited by pulmonary artery banding and ligation of the ductus arteriosus in three patients and by a Blalock-Taussig shunt in one. Conduit obstruction of systemic blood flow developed in two of these infants, and pulmonary vascular abnormalities precluded reparative surgery in the other two. In the other six patients, systemic blood flow was established by direct anastomosis of the proximal main pulmonary artery to the ascending aorta and aortic arch. The pulmonary vasculature was protected by providing pulmonary flow through a central or Blalock-Taussig shunt. The interatrial communication was enlarged by atrial septectomy or balloon atrial septotomy. One infant had progressive tricuspid regurgitation necessitating valve replacement. One, in whom balloon atrial septotomy had been performed, developed an obstructive interatrial communication necessitating late atrial septectomy. These six patients were candidates for physiologic correction. To date, three patients have undergone a modified Fontan procedure; two are clinically well at 9 and 12 months after surgery. Three patients await this procedure.
Authors:
P Lang; W I Norwood
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  68     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1983 Jul 
Date Detail:
Created Date:  1983-07-29     Completed Date:  1983-07-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  104-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Blood Circulation
Heart Catheterization
Heart Defects, Congenital / physiopathology,  surgery*
Hemodynamics*
Humans
Infant
Infant, Newborn
Palliative Care
Postoperative Period
Pulmonary Circulation
Vascular Resistance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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