Right ventricle–pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome

Sano, Shunji; Ishino, Kozo; Kawada, Manabu; Arai, Sadahiko; Kasahara, Shingo; Asai, Tomohiro; Masuda, Zenichi; Takeuchi, Mamoru; Ohtsuki, Shinichi

doi:10.1016/s0022-5223(02)73575-7

Cited by 441 publications

(166 citation statements)

References 22 publications

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“…The development of the RV-PA shunt in the last decade has improved patient's mortality and morbidity [15]. Since Sano et al [16] reported their experience with the nonvalved RV-PA shunt in 2003, this modification has been widely used. However, it remains controversial whether the RV-PA shunt truly improves the outcome of the Norwood procedure.…”

Section: Discussionmentioning

confidence: 99%

Norwood procedure with non-valved right ventricle to pulmonary artery shunt improves ventricular energetics despite the presence of diastolic regurgitation: a theoretical analysis

et al. 2011

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When the Norwood procedure is conducted for the hypoplastic left heart syndrome using a non-valved right ventricle (RV) to pulmonary artery (PA) shunt, diastolic regurgitation from PA to RV may have an adverse effect on postoperative hemodynamics. In this study, we examined the impact of the diastolic regurgitation on ventricular energetics by computational analysis using a combination of a time-varying elastance chamber model and a modified three-element Windkessel vascular model. This study revealed that use of the valved or non-valved RV-PA shunt eliminated pulmonary over-circulation which was observed when using the systemic to pulmonary artery shunt (modified Blalock-Taussig shunt). Although the valved RV-PA shunt improved pulmonary blood supply and consequently increased pulmonary artery flow and oxygen saturation compared to the non-valved RV-PA shunt, the non-valved RV-PA shunt improved ventricular energetics in spite of the presence of PA to RV regurgitation.

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Section: Discussionmentioning

confidence: 99%

Norwood procedure with non-valved right ventricle to pulmonary artery shunt improves ventricular energetics despite the presence of diastolic regurgitation: a theoretical analysis

et al. 2011

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“…We hold that rudimentary right ventricle to pulmonary artery shunt in the Norwood procedure would be a safe option to improve postoperative hemodynamic status rather than systemic to pulmonary artery shunt. 2 The risk of stenosis at a ventricular anastomosis site in this modifi cation would be less than an anastomosis on the left ventricle. The thickness and stiffness of ventricular walls are inevitably different between the two.…”

Section: Discussionmentioning

confidence: 96%

Rudimentary right ventricle to pulmonary artery shunt in the Norwood procedure

Tateishi

Kawada

Morita

et al. 2010

Gen Thorac Cardiovasc Surg

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We describe here successful palliative repair of tricuspid atresia, hypoplastic right ventricle, transposition of the great arteries, and hypoplastic aortic arch in a neonate. The repair consisted of the Norwood procedure with a rudimentary right ventricle to pulmonary artery shunt, which was located on the right side of a neo-aorta. This procedure could be a useful adjunct to avoid left ventriculotomy and its subsequent dysfunction.

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“…For performing this type of modification, we were inspired by Sano and colleagues [6], who described right ventricle-to-pulmonary artery shunting during firststage palliation of hypoplastic left heart syndrome. When a ringed PTFE graft is to be used in this technique, 2 pledgeted purse-string sutures are placed around the ventriculotomy.…”

Section: Commentmentioning

confidence: 99%

An Easy Modification of Tube Graft Interposition During Fenestration in Borderline Fontan Circulation

Sarıoğlu

Şişli

Yalçınbaş

et al. 2015

The Annals of Thoracic Surgery

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One of the options for the management of borderline/failing extracardiac Fontan circulation is surgical creation of an atrial fenestration to decompress the systemic venous compartment and improve cardiac output. Depending on the body surface area of the patient, a 5- to 10-mm polytetrafluoroethylene (PTFE) tube graft can be used. When fenestration is required in a patient with failing Fontan circulation, particularly in redo cases, application of a side-biting clamp may be challenging because of adhesions and a thickened atrial wall. In this article, we present our off-pump technique of atrial-side anastomosis of PTFE graft interposition between an extracardiac Fontan conduit and the atrium without using a side-biting clamp.

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Right ventricle–pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome

Cited by 441 publications

References 22 publications

Norwood procedure with non-valved right ventricle to pulmonary artery shunt improves ventricular energetics despite the presence of diastolic regurgitation: a theoretical analysis

Norwood procedure with non-valved right ventricle to pulmonary artery shunt improves ventricular energetics despite the presence of diastolic regurgitation: a theoretical analysis

Rudimentary right ventricle to pulmonary artery shunt in the Norwood procedure

An Easy Modification of Tube Graft Interposition During Fenestration in Borderline Fontan Circulation

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