Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome
| Autor: | Hakan Akintuerk, Christian Apitz, Juergen Bauer, Reza Razavi, Tarique Hussain, Conal Austin, Pauline Hachmann, Caner Salih, Dietmar Schranz, David Anderson, Hannah Bellsham-Revell, Mohamed S. Nassar, Gerald F. Greil, Heiner Latus, Can Yerebakan, James Wong |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Heart Ventricles Population Aorta Thoracic Kaplan-Meier Estimate Pulmonary Artery 030204 cardiovascular system & hematology Fontan Procedure Norwood Procedures 030218 nuclear medicine & medical imaging Pulmonary artery banding Hypoplastic left heart syndrome 03 medical and health sciences 0302 clinical medicine medicine.artery Internal medicine Hypoplastic Left Heart Syndrome Heart rate medicine Journal Article Humans education Blalock-Taussig Procedure education.field_of_study Ventricular function business.industry Palliative Care Infant medicine.disease Norwood Operation Surgery Child Preschool Pulmonary artery Ventricular Function Right Cardiology Female Cardiology and Cardiovascular Medicine business Magnetic Resonance Angiography Shunt (electrical) |
| Zdroj: | Latus, H, Nassar, M S, Wong, J, Hachmann, P, Bellsham-Revell, H, Hussain, T, Apitz, C, Salih, C, Austin, C, Anderson, D, Yerebakan, C, Akintuerk, H, Bauer, J, Razavi, R, Schranz, D & Greil, G 2017, ' Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome ', Heart . https://doi.org/10.1136/heartjnl-2017-311532 |
| DOI: | 10.1136/heartjnl-2017-311532 |
| Popis: | ObjectiveNorwood and hybrid procedure are two options available for initial palliation of patients with hypoplastic left heart syndrome (HLHS). Our study aimed to assess potential differences in right ventricular (RV) function and pulmonary artery dimensions using cardiac magnetic resonance (CMR) in survivors with HLHS.Methods42 Norwood (mean age 2.4±0.8) and 44 hybrid (mean age 2.0±1.0 years) patients were evaluated by CMR after stage II palliation prior to planned Fontan completion. Initial stage I Norwood procedure was performed using a modified Blalock-Taussig shunt, while the hybrid procedure consisted of bilateral pulmonary artery banding and arterial duct stenting. Need for reinterventions and subsequent outcomes were also assessed.ResultsNorwood patients had larger RV end-diastolic dimensions (91±23 vs 80±31 mL/m2, p=0.004) and lower heart rate (90±15 vs 102±13, p2/m2, p=0.02), and reintervention rate was significantly higher in the hybrid group whereas subsequent outcome did not differ significantly (p=0.24).ConclusionsNorwood and hybrid strategy were associated with equivalent and preserved global RV pump function while development of the pulmonary arteries and reintervention rate were superior using the Norwood approach. Impaired RV myocardial deformation as a potential marker of early RV dysfunction in the hybrid group may have a negative long-term impact in this population. |
| Databáze: | OpenAIRE |
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