The modified norwood palliation on a beating heart

Kishimoto, Hiroyuki; Kawahira, Youichi; Kawata, Hiroaki; Miura, Takuya; Iwai, Shigemitu; Mori, Toru

doi:10.1016/s0022-5223(99)70118-2

Cited by 101 publications

(52 citation statements)

References 7 publications

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“…More recently, the right ventricle-to-pulmonary artery (RVPA) shunt modification of the Norwood procedure was revived. 2 This modification offers the advantage of separating the effects of changes in pulmonary vascular resistance from the systemic circulation while providing adequate pulmonary blood flow. This may lead to better survival rates.…”

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confidence: 99%

Two-Year Survival and Mental and Psychomotor Outcomes After the Norwood Procedure

Atallah

Dinu²,

Joffe³

et al. 2008

Circulation

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Background-The Norwood procedure for stage 1 palliation of hypoplastic left heart syndrome is performed with either the modified Blalock-Taussig (MBTS) or the right ventricle-to-pulmonary artery (RVPA) shunt. In our institution, surgical practice changed from use of the MBTS to use of the RVPA shunt in 2002. We analyzed survival and mental and psychomotor outcomes of the 2 consecutive surgical eras. Methods and Results-Between September 1996 and July 2005, 94 neonates with hypoplastic left heart syndrome underwent the Norwood procedure. Patients were recruited as neonates and followed up prospectively. Health, mental, and psychomotor outcomes (Bayley Scales of Infant Development-II) were assessed at 2 years. The study subjects were from the Norwood-MBTS era (nϭ62; 1996 to 2002) or the Norwood-RVPA era (nϭ32; 2002 to 2005). In the MBTS era, early and 2-year mortality rates were 23% (14/62) and 52% (32/62); the mean (SD) mental and psychomotor developmental indices were 79 (18) and 67 (19). In the RVPA era, early and 2-year mortality rates were 6% (2/32) and 19% (6/32); the mean (SD) mental and psychomotor developmental indices were 85 (18) and 78 (18). The 2-year mortality rate (Pϭ0.002) and the psychomotor developmental index (Pϭ0.029) were improved in the more recent surgical era. On multivariable Cox regression analysis, postoperative highest serum lactate independently predicted 2-year mortality in the MBTS and RVPA eras. Conclusions-Analysis of 2 consecutive surgical eras of hypoplastic left heart syndrome patients undergoing the Norwood procedure showed a significant improvement in 2-year survival and psychomotor development in the more recent era.

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confidence: 99%

Two-Year Survival and Mental and Psychomotor Outcomes After the Norwood Procedure

Atallah

Dinu²,

Joffe³

et al. 2008

Circulation

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“…12 Two of the early reports from Japan about the RV-PA conduit modification described integrating a valve into the pathway. Kishimoto made a bicuspid valve from xenopericardium, 13 and Murakami used a valved saphenous vein homograft. 14 Eliminating diastolic regurgitation into the right ventricle should further reduce volume load and increase hemodynamic efficiency.…”

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confidence: 99%

Homograft Valved Right Ventricle to Pulmonary Artery Conduit as a Modification of the Norwood Procedure

Reinhartz

Reddy²,

Petrossian³

et al. 2006

Circulation

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“…To modulate these detrimental physiological features, the use of a right ventricle to pulmonary artery conduit (RV/PA), initially reported in the early attempts of surgical palliation for HLHS by Norwood and colleagues, 5 has been revisited. 6,7 This report compares the experience in two centers with the use of a RV to PA conduit to provide pulmonary blood flow as opposed to the conventional approach using a modified Blalock-Taussig shunt in neonates undergoing Stage I Norwood reconstruction for HLHS. No other aspect of the surgical technique or perioperative management has been altered.…”

mentioning

confidence: 99%

Right Ventricle to Pulmonary Artery Conduit Improves Outcome After Stage I Norwood for Hypoplastic Left Heart Syndrome

et al. 2003

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The modified norwood palliation on a beating heart

Cited by 101 publications

References 7 publications

Two-Year Survival and Mental and Psychomotor Outcomes After the Norwood Procedure

Two-Year Survival and Mental and Psychomotor Outcomes After the Norwood Procedure

Homograft Valved Right Ventricle to Pulmonary Artery Conduit as a Modification of the Norwood Procedure

Right Ventricle to Pulmonary Artery Conduit Improves Outcome After Stage I Norwood for Hypoplastic Left Heart Syndrome

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