Impact of right ventricle to pulmonary artery conduit on outcome of the modified norwood procedure
To determine and compare outcome of the modified Norwood procedure using either a systemic to pulmonary artery (SPA) shunt or right ventricle to pulmonary artery (RV-PA) conduit in a consecutive series of neonates at a single institution. The medical records were retrospectively examined for preoper...
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| Veröffentlicht in: | The Annals of thoracic surgery 2004-05, Vol.77 (5), p.1727-1733 |
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| container_title | The Annals of thoracic surgery |
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| creator | Azakie, Anthony Martinez, Daniel Sapru, Anil Fineman, Jeffrey Teitel, David Karl, Tom R |
| description | To determine and compare outcome of the modified Norwood procedure using either a systemic to pulmonary artery (SPA) shunt or right ventricle to pulmonary artery (RV-PA) conduit in a consecutive series of neonates at a single institution.
The medical records were retrospectively examined for preoperative demographic and echocardiographic data, operative variables, and postoperative clinical and hemodynamic data. From November 2001 to March 2003, 21 neonates had a modified Norwood procedure (SPA shunt, n = 8; RV-PA conduit, n = 13) at a median age of 5 days (range 1 to 18 days) and a median weight of 2.9 kg (range 1.7 to 4.1 kg). Of the 21 infants, 12 were considered high risk due to presence of low birth weight (n = 4), extracardiac or genetic anomalies (n = 5) or obstruction to pulmonary venous return (n = 5). Nine “high risk” infants were in the RV-PA conduit group.
Overall Norwood operation survival was 90% (19/21) and did not differ between groups. There were 2/19 interstage deaths and Kaplan-Meier survival at 1 year is 79%. Neonates in the RV-PA conduit group had significantly higher diastolic blood pressures at 1, 6, and 24 hours postoperatively (
p < 0.05). Neonates in the SPA shunt group had significantly higher heart rates at 1 hour postoperatively (
p < 0.05) than those in the RV-PA group. There was a trend to higher number of ventilatory interventions to balance Qp:Qs in the SPA shunt group (
p = 0.06).
In a relatively high-risk group, neonates having an RV-PA conduit as part of the Norwood procedure have favorable postoperative hemodynamics and a good likelihood of stage I survival. |
| doi_str_mv | 10.1016/j.athoracsur.2003.10.002 |
| format | Article |
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The medical records were retrospectively examined for preoperative demographic and echocardiographic data, operative variables, and postoperative clinical and hemodynamic data. From November 2001 to March 2003, 21 neonates had a modified Norwood procedure (SPA shunt, n = 8; RV-PA conduit, n = 13) at a median age of 5 days (range 1 to 18 days) and a median weight of 2.9 kg (range 1.7 to 4.1 kg). Of the 21 infants, 12 were considered high risk due to presence of low birth weight (n = 4), extracardiac or genetic anomalies (n = 5) or obstruction to pulmonary venous return (n = 5). Nine “high risk” infants were in the RV-PA conduit group.
Overall Norwood operation survival was 90% (19/21) and did not differ between groups. There were 2/19 interstage deaths and Kaplan-Meier survival at 1 year is 79%. Neonates in the RV-PA conduit group had significantly higher diastolic blood pressures at 1, 6, and 24 hours postoperatively (
p < 0.05). Neonates in the SPA shunt group had significantly higher heart rates at 1 hour postoperatively (
p < 0.05) than those in the RV-PA group. There was a trend to higher number of ventilatory interventions to balance Qp:Qs in the SPA shunt group (
p = 0.06).
In a relatively high-risk group, neonates having an RV-PA conduit as part of the Norwood procedure have favorable postoperative hemodynamics and a good likelihood of stage I survival.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2003.10.002</identifier><identifier>PMID: 15111174</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Vessel Prosthesis Implantation ; Cardiac Surgical Procedures - methods ; Cardiac Surgical Procedures - mortality ; Cardiology. Vascular system ; Female ; Heart Defects, Congenital - surgery ; Hemodynamics ; Hospital Mortality ; Humans ; Infant, Newborn ; Male ; Medical sciences ; Pneumology ; Proportional Hazards Models ; Retrospective Studies</subject><ispartof>The Annals of thoracic surgery, 2004-05, Vol.77 (5), p.1727-1733</ispartof><rights>2004 The Society of Thoracic Surgeons</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c502t-3ab62227ced430253290f7fc1dbb8811d8362c72bac11535bc06b1ce03c7bc6f3</citedby><cites>FETCH-LOGICAL-c502t-3ab62227ced430253290f7fc1dbb8811d8362c72bac11535bc06b1ce03c7bc6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.athoracsur.2003.10.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15725671$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15111174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Azakie, Anthony</creatorcontrib><creatorcontrib>Martinez, Daniel</creatorcontrib><creatorcontrib>Sapru, Anil</creatorcontrib><creatorcontrib>Fineman, Jeffrey</creatorcontrib><creatorcontrib>Teitel, David</creatorcontrib><creatorcontrib>Karl, Tom R</creatorcontrib><title>Impact of right ventricle to pulmonary artery conduit on outcome of the modified norwood procedure</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>To determine and compare outcome of the modified Norwood procedure using either a systemic to pulmonary artery (SPA) shunt or right ventricle to pulmonary artery (RV-PA) conduit in a consecutive series of neonates at a single institution.
The medical records were retrospectively examined for preoperative demographic and echocardiographic data, operative variables, and postoperative clinical and hemodynamic data. From November 2001 to March 2003, 21 neonates had a modified Norwood procedure (SPA shunt, n = 8; RV-PA conduit, n = 13) at a median age of 5 days (range 1 to 18 days) and a median weight of 2.9 kg (range 1.7 to 4.1 kg). Of the 21 infants, 12 were considered high risk due to presence of low birth weight (n = 4), extracardiac or genetic anomalies (n = 5) or obstruction to pulmonary venous return (n = 5). Nine “high risk” infants were in the RV-PA conduit group.
Overall Norwood operation survival was 90% (19/21) and did not differ between groups. There were 2/19 interstage deaths and Kaplan-Meier survival at 1 year is 79%. Neonates in the RV-PA conduit group had significantly higher diastolic blood pressures at 1, 6, and 24 hours postoperatively (
p < 0.05). Neonates in the SPA shunt group had significantly higher heart rates at 1 hour postoperatively (
p < 0.05) than those in the RV-PA group. There was a trend to higher number of ventilatory interventions to balance Qp:Qs in the SPA shunt group (
p = 0.06).
In a relatively high-risk group, neonates having an RV-PA conduit as part of the Norwood procedure have favorable postoperative hemodynamics and a good likelihood of stage I survival.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cardiac Surgical Procedures - mortality</subject><subject>Cardiology. Vascular system</subject><subject>Female</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Hemodynamics</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pneumology</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEFvEzEQhS1ERdPCX0C-wG2D7Y3XmyNUBSpV4lLOlj2eJY5218H2FvXfd6JEKrf6MrLf92Y8jzEuxVoK2X3Zr13dpeygLHmthGjpeS2EesNWUmvVdEpv37KVIKXZbI2-ZFel7OmqSH7HLqWWdMxmxfzddHBQeRp4jn92lT_iXHOEEXlN_LCMU5pdfuIuV6QCaQ5LJHzmaamQJjw66w75lEIcIgY-p_wvpcAPOQGGJeN7djG4seCHc71mv7_fPtz8bO5__bi7-XrfgBaqNq3znVLKkGnTCqVbtRWDGUAG7_teytC3nQKjvAMpdas9iM5LQNGC8dAN7TX7fOpLk_8uWKqdYgEcRzdjWoo1su-01hsC-xMIOZWScbCHHCfa0kphj_navX3J1x7zPSqUHlk_nmcsfsLwYjwHSsCnM-AKuHHIboZY_uOM0p2RxH07cUiJPEbMtkDEmZaPGaHakOLrv3kG-wef2Q</recordid><startdate>20040501</startdate><enddate>20040501</enddate><creator>Azakie, Anthony</creator><creator>Martinez, Daniel</creator><creator>Sapru, Anil</creator><creator>Fineman, Jeffrey</creator><creator>Teitel, David</creator><creator>Karl, Tom R</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040501</creationdate><title>Impact of right ventricle to pulmonary artery conduit on outcome of the modified norwood procedure</title><author>Azakie, Anthony ; Martinez, Daniel ; Sapru, Anil ; Fineman, Jeffrey ; Teitel, David ; Karl, Tom R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c502t-3ab62227ced430253290f7fc1dbb8811d8362c72bac11535bc06b1ce03c7bc6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Cardiac Surgical Procedures - mortality</topic><topic>Cardiology. Vascular system</topic><topic>Female</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Hemodynamics</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pneumology</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Azakie, Anthony</creatorcontrib><creatorcontrib>Martinez, Daniel</creatorcontrib><creatorcontrib>Sapru, Anil</creatorcontrib><creatorcontrib>Fineman, Jeffrey</creatorcontrib><creatorcontrib>Teitel, David</creatorcontrib><creatorcontrib>Karl, Tom R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Azakie, Anthony</au><au>Martinez, Daniel</au><au>Sapru, Anil</au><au>Fineman, Jeffrey</au><au>Teitel, David</au><au>Karl, Tom R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of right ventricle to pulmonary artery conduit on outcome of the modified norwood procedure</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2004-05-01</date><risdate>2004</risdate><volume>77</volume><issue>5</issue><spage>1727</spage><epage>1733</epage><pages>1727-1733</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>To determine and compare outcome of the modified Norwood procedure using either a systemic to pulmonary artery (SPA) shunt or right ventricle to pulmonary artery (RV-PA) conduit in a consecutive series of neonates at a single institution.
The medical records were retrospectively examined for preoperative demographic and echocardiographic data, operative variables, and postoperative clinical and hemodynamic data. From November 2001 to March 2003, 21 neonates had a modified Norwood procedure (SPA shunt, n = 8; RV-PA conduit, n = 13) at a median age of 5 days (range 1 to 18 days) and a median weight of 2.9 kg (range 1.7 to 4.1 kg). Of the 21 infants, 12 were considered high risk due to presence of low birth weight (n = 4), extracardiac or genetic anomalies (n = 5) or obstruction to pulmonary venous return (n = 5). Nine “high risk” infants were in the RV-PA conduit group.
Overall Norwood operation survival was 90% (19/21) and did not differ between groups. There were 2/19 interstage deaths and Kaplan-Meier survival at 1 year is 79%. Neonates in the RV-PA conduit group had significantly higher diastolic blood pressures at 1, 6, and 24 hours postoperatively (
p < 0.05). Neonates in the SPA shunt group had significantly higher heart rates at 1 hour postoperatively (
p < 0.05) than those in the RV-PA group. There was a trend to higher number of ventilatory interventions to balance Qp:Qs in the SPA shunt group (
p = 0.06).
In a relatively high-risk group, neonates having an RV-PA conduit as part of the Norwood procedure have favorable postoperative hemodynamics and a good likelihood of stage I survival.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15111174</pmid><doi>10.1016/j.athoracsur.2003.10.002</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Vessel Prosthesis Implantation Cardiac Surgical Procedures - methods Cardiac Surgical Procedures - mortality Cardiology. Vascular system Female Heart Defects, Congenital - surgery Hemodynamics Hospital Mortality Humans Infant, Newborn Male Medical sciences Pneumology Proportional Hazards Models Retrospective Studies |
| title | Impact of right ventricle to pulmonary artery conduit on outcome of the modified norwood procedure |
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