Document Detail


The RV-PA conduit stimulates better growth of the pulmonary arteries in hypoplastic left heart syndrome.
MedLine Citation:
PMID:  15848317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2005-04-25     Completed Date:  2005-09-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-6     Citation Subset:  IM    
Affiliation:
Department of Paediatric Cardiac Surgery, Diana, Princess of Wales Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
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MeSH Terms
Descriptor/Qualifier:
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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