Beating-Heart Surgery for Hypoplastic Left Heart Syndrome With Coronary Artery Fistulas

Matsushima, Shunsuke; Oshima, Yoshihiro; Maruo, Ayako; Hasegawa, Tomomi; Matsuhisa, Hironori; Noda, Ryuichi; Iwaki, Ryuma

doi:10.1016/j.athoracsur.2014.06.112

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Ventriculo‐coronary communication is common in patients with pulmonary atresia with an intact ventricular septum (Matsushima et al, 2014; Taddei et al, 2003; Yozgat et al, 2020). Ventriculo‐coronary communication in hypoplastic left heart syndrome is thought to be remnants of ongoing embryonic communication between the coronaries and the ventricles and is comparable to ventriculo‐coronary communication in pulmonary atresia with an intact ventricular septum (Al‐Hijji et al, 2021; Chaoui et al, 2002; Gowda et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis: Hypoplastic left heart syndrome in combination with ventriculo‐coronary communication

Jiali,

Dongmei,

Jiangli

et al. 2023

Birth Defects Research

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BackgroundBoth hypoplastic left heart syndrome and ventriculo‐coronary communication are extremely rare congenital cardiac conditions.CaseThe diagnosis of hypoplastic left heart syndrome combined with endocardial fibroelastosis and ventriculo‐coronary communication was made in a pregnant woman at 24 weeks of gestation. Interestingly, unlike diastolic flow from the coronary artery to the left ventricle in typical ventriculo‐coronary communication, this fetus showed a systolic flow from the left ventricle to the coronary artery.ConclusionTo the best of our knowledge, this is the first study to present only a systolic flow signal in hypoplastic left heart syndrome combined with ventriculo‐coronary communication in prenatal ultrasonography.

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Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis: Hypoplastic left heart syndrome in combination with ventriculo‐coronary communication

Jiali,

Dongmei,

Jiangli

et al. 2023

Birth Defects Research

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“…28 Others are studying the effect of performing the Norwood operation without cardiac arrest, providing continuous coronary perfusion throughout the procedure. 27…”

Section: Coronary Fistulaementioning

confidence: 99%

“…26 Although the exact mechanism is not known, large fistulae may lead to coronary malperfusion during cardiopulmonary bypass for surgical palliation. [26][27][28] To mitigate this, some suggest the use of continuous antegrade cold blood cardioplegia (flow of 30-40 mL/min for line pressure between 150 and 170 mmHg) to the aortic root up to the final step of the Norwood operation (neo-aortic root reconstruction) for enhanced myocardial protection. 28 Others are studying the effect of performing the Norwood operation without cardiac arrest, providing continuous coronary perfusion throughout the procedure.…”

Section: Coronary Fistulaementioning

confidence: 99%

“…Results from both the SVR and CHSS trials have shown that moderate to severe tricuspid regurgitation portends a poor outcome. [27][28][29][30][31] Mechanisms of insufficiency include valvar dysplasia, annular dilatation, leaflet prolapse, accessory orifices, abnormal subvalvar apparatus, and Ebstenoid features. Although the mechanism is unknown, patients with more severe left ventricular hypoplasia tend to have worse progression of tricuspid regurgitation.…”

Section: Tricuspid Valve Regurgitationmentioning

confidence: 99%

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High-Risk Anatomic Subsets in Hypoplastic Left Heart Syndrome

Geoffrion

Fuller

2022

World J Pediatr Congenit Heart Surg

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Despite overall improvements in outcomes for patients with hypoplastic left heart syndrome, there remain anatomic features that can place these patients at higher risk throughout their treatment course. These include severe preoperative obstruction to pulmonary venous return, restrictive atrial septum, coronary fistulae, severe tricuspid regurgitation, smaller ascending aorta diameter (especially if <2 mm), and poor ventricular function. The risk of traditional staged palliation has led to the development of alternative strategies for such patients. To further improve the outcomes, we must continue to diligently examine and study anatomic details in HLHS patients.

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“…Despite not using adjustable bPAB, we were able to dilate the PAs bilaterally. The NW-G procedure was performed using the beating-heart Norwood technique with continuous coronary perfusion when possible [7]. Although we tried to incise the aortic valve to decompress the left ventricle, this could not be achieved safely under direct vision.…”

Section: Commentmentioning

confidence: 99%

Hypoplastic Left Heart Syndrome With Right Ventricle Compression

Fuchigami

Nishioka

Takahashi

et al. 2015

The Annals of Thoracic Surgery

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A male neonate presented with the aortic atresia-mitral stenosis (AA-MS) variant of hypoplastic left heart syndrome (HLHS) wherein the suprasystemic left ventricular (LV) pressure and large left ventricle shifted the intraventricular septum. A compressed right ventricle made it difficult to maintain stroke volume. To avoid high right ventricular (RV) volume load and output, we used a 2-stage Norwood-Glenn (NW-G) procedure. Bilateral pulmonary artery banding (bPAB) was performed on day of life (DOL) 4. On DOL 58, we performed percutaneous balloon dilation of the bPAB portion. At age 3 months, the NW-G procedure was performed without peripheral pulmonary hypoplasia. The patient is currently doing well.

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Beating-Heart Surgery for Hypoplastic Left Heart Syndrome With Coronary Artery Fistulas

Cited by 5 publications

References 7 publications

Prenatal diagnosis: Hypoplastic left heart syndrome in combination with ventriculo‐coronary communication

Prenatal diagnosis: Hypoplastic left heart syndrome in combination with ventriculo‐coronary communication

High-Risk Anatomic Subsets in Hypoplastic Left Heart Syndrome

Hypoplastic Left Heart Syndrome With Right Ventricle Compression

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