| ID | 62188 |
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| Author |
Kobayashi, Yasuyuki
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital
ORCID
Kaken ID
Kotani, Yasuhiro
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital
Kuroko, Yosuke
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital
Kawabata, Takuya
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital
Sano, Shunji
Department of Pediatric Cardiothoracic Surgery, University of California
Kaken ID
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| Abstract | Objectives: The aim of this study was to evaluate the long-term outcomes of the Norwood procedure with right ventricle-pulmonary artery (RV-PA) conduit for hypoplastic left heart complex (HLHC).
Methods: A retrospective observational study was performed in 136 patients with HLHC who underwent a Norwood procedure with RV-PA conduit between 1998 and 2017. The probabilities of survival, reintervention and Fontan completion were analyzed. Results: Stage 1 survival was 91.9% (125/136). Reintervention for pulmonary artery stenosis was needed for 22% and 30% at stage 2 and 3, respectively, while 15% underwent reintervention for aortic arch recoarctation. Among 106 bidirectional Glenn survivors, 93 (68% of the total number of patients) had a Fontan completion, while four were not considered to be Fontan candidates. Risk factors for overall mortality included weighing <2.5 kg at the time of the Norwood procedure, intact atrium septum, total anomalous pulmonary vein connection, and more than mild atrioventricular regurgitation at the time of the Norwood procedure. Overall survival was 80.9%, 72.3% and 62.8% at 1, 5, and 20 years, respectively. Conclusions: Probabilities of survival and Fontan completion were acceptable under the current surgical strategy incorporating RV-PA Norwood procedure as the first palliation. Incorporating a strategy to maintain pulmonary artery growth and ventricular function through the staged repair is of prime importance. Further studies are necessary to observe changes in atrioventricular regurgitation as well as in right ventricular function, in patients who require atrioventricular valve interventions during the staged Fontan completion. |
| Keywords | Hypoplastic left heart complex
Norwood
RV-PA conduit
Fontan completion
Tricuspid regurgitation
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| Note | This is a pre-copyedited, author-produced version of an article accepted for publication in [European Journal of Cardio-Thoracic Surgery] following peer review. The version of record [European Journal of Cardio-Thoracic Surgery, Volume 58, Issue 2, August 2020, Pages 230–236] is available online at: https://doi.org/10.1093/ejcts/ezaa041
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| Published Date | 2020-8-1
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| Publication Title |
European Journal of Cardio-Thoracic Surgery
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| Volume | volume59
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| Issue | issue4
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| Publisher | Oxford University Press (OUP)
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| Start Page | 230
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| End Page | 236
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| ISSN | 1010-7940
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| NCID | AA1072688X
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| Content Type |
Journal Article
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| language |
English
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| OAI-PMH Set |
岡山大学
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| File Version | author
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| Related Url | isVersionOf https://doi.org/10.1093/ejcts/ezaa041
isVersionOf https://doi.org/10.1093/ejcts/ezaa483
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