Restrictive left atrial outflow adversely affects outcome after the modified Norwood procedure

Abstract

Restrictive left atrial outflow adversely affects outcome after modified Norwood procedure. Abnormal pulmonary vasculature leading to insufficient pulmonary perfusion is incriminated. To improve outcome, implantation of larger size modified Blalock-Taussig or right ventricle-to-pulmonary artery shunts and routine use of postoperative mechanical assist device should be considered.

Survival and Clinical Course at Fontan After Stage One Palliation With Either a Modified Blalock-Taussig Shunt or a Right Ventricle to Pulmonary Artery Conduit

“…Given the number of events in the present analysis (n ϭ 22), we considered for inclusion in the model only those perioperative variables found to be significant in univariate analyses (p Ͻ 0.05), the principle variable of interest (S1P operative group), and a previously reported strong risk factor for surgical death, the presence of an intact atrial septum at birth (20,21). Both the proportional hazards assumption Fontan Outcomes After mBTS or RV to PA Conduit and the functional form of continuous model variables were assessed based on cumulative sums of martingale-based residuals (22).…”

Neonatal decompensation before surgery in hypoplastic left heart syndrome: a case control study

“…The most common initial treatment remains the Norwood 1 procedure, with most infants undergoing this procedure in the 1st week of life 2. Risk factors for poor outcome during and after Norwood 1 surgery are well documented, and include: low birth weight,3 4 presence of genetic and/or extracardiac abnormalities,4–6 and certain anatomical subtypes, such as aortic atresia with mitral stenosis6–8 or obstructed pulmonary venous return 9 10…”

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“…[2][3][4][5][6][7] In these diseases signs of PFO restriction should alert the clinician and require urgent Rashkind procedure or anticipation of surgical correction/palliation. [2][3][4][5][6][7] Foramen ovale is easily evaluated by echocardiography.…”