• Przegla̧d lekarski · Jan 2002

    Comparative Study

    [Early postoperative period in children with hypoplastic left heart syndrome in the comparison of classic and modified Norwood procedures].

    • Edward Malec, Katarzyna Januszewska, Jacek Pajak, Jacek Kołcz, and Tomasz Mroczek.
    • Klinika Kardiochirurgii Dzieciecej Katedry Chirurgii Pediatrycznej Polsko-Amerykański Instytutu Pediatrii UJ 30-663 Kraków, ul. Wielicka 265. mimalec@cyf-kr.edu.pl
    • Prz. Lek. 2002 Jan 1; 59 Suppl 1: 28-33.

    IntroductionThe Norwood operation in neonates with hypoplastic left heart syndrome is associated with very high mortality.AimTo compare early postoperative period in children who underwent classic operation to that in patients who underwent a new modification of the Norwood procedure.MethodsEvaluation of the early postoperative period (72 h after the operation) in patients who underwent classic operation: Group 1 (31 children) and patients in whom modified Norwood procedure was performed: Group 2 (18 children). The surgical technique of the modified Norwood procedure was presented (right ventricle- to = pulmonary artery shunt and neo-aorta reconstruction by direct anastomosis between aortic arch and main pulmonary artery).ResultsIn Group 1 in 15 (48.4%) children circulatory collapse occurred, requiring resuscitation, which was unsuccessful in 9 (60%) cases. In Group 2 one child died and early postoperative period of the other was uneventful. The mean circulatory arrest time in deep hypothermia was significantly (p = 0.002) shorter in Group 2 (mean: 33.7 +/- 8.7 min, range 25-53 min) than in Group 2 (mean: 54.1 +/- 6.6 min, range 41-76 min) and cardiopulmonary bypass time was not significantly prolonged (Group 1: mean 70.5 +/- 24.2 min, range 48-167 min; Group 2: mean 62.5 +/- 9.6 min, 39-84 min) (p = 0.765). In Group 2 there was significantly higher diastolic pressure 4, 8, 12, 24 and 36 h after the operation (p < 0.001, p = 0.005, p = 0.037, p = 0.017, p = 0.022, respectively).ConclusionThe new modification of the Norwood procedure ensures stable conditions in early postoperative period. We believe that short circulatory arrest time without prolongation of cardiopulmonary bypass time and higher diastolic pressure (the location of the proximal shunt end beneath the valve of the systemic circulation) improves the function of the heart.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…