| The RV-PA conduit stimulates better growth of the pulmonary arteries in hypoplastic left heart syndrome. | |
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MedLine Citation:
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PMID: 15848317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This retrospective study compared the size of the central pulmonary arteries in patients with hypoplastic left heart syndrome (HLHS) following either a classical Norwood or Norwood procedure with a right ventricle to pulmonary artery (RV-PA) conduit. METHODS: Between May 2001 and May 2003, 30 patients with HLHS underwent cardiac catheterization prior to stage II palliation. Patients were initially palliated with a classical Norwood (Classical group, n=18) or Norwood procedure with RV-PA conduit (RV-PA group; n=12). Indexed maximum and minimum diameters of the LPA and RPA were measured using the McGoon ratio. Cardiac catheterisation was performed at a median age of 4.0 months. There was no difference in the time interval to catheterisation (P=0.13), Qp:Qs (P=0.41) or median haemoglobin (P=0.42) between the groups. RESULTS: The combined PA diameter was larger in the RV-PA group (B) than the classical group (A) (1.99+/-0.38 versus 1.63+/-0.29, P<0.05). There were marked differences in the relative size of the pulmonary arteries between the two groups. In RV-PA patients, the LPA and RPA sizes were comparable (0.99+/-0.22 versus 1.00+/-0.31, P=1.00) whereas, in the classical group, the LPA was smaller than the RPA (0.75+/-0.15 versus 0.88+/-0.17, P<0.05). Both techniques were also associated with discrete PA stenoses at the site of shunt insertion. Stenoses were more severe in RV-PA group (RV-PA), causing a 42+/-16% reduction in the combined PA diameter compared with a 28+/-18% reduction in Classical group (classical) (P<0.05). CONCLUSIONS: The Norwood procedure with RV-PA conduit is associated with better and more evenly distributed central pulmonary artery growth. Nevertheless, it is also associated with central PA stenoses, which may require subsequent reconstruction. |
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Authors:
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Elizabeth M Rumball; Simon P McGuirk; Oliver Stümper; Simon J Laker; Joseph V de Giovanni; John G Wright; David J Barron; William J Brawn |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 27 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-04-25 Completed Date: 2005-09-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 801-6 Citation Subset: IM |
Affiliation:
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Department of Paediatric Cardiac Surgery, Diana, Princess of Wales Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical Blood Vessel Prosthesis Implantation Cardiac Surgical Procedures Constriction, Pathologic Heart Catheterization Heart Ventricles / pathology, surgery Humans Hypoplastic Left Heart Syndrome / pathology, surgery* Infant Infant, Newborn Palliative Care* Pulmonary Artery / pathology, surgery* Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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