Right ventricle-to-pulmonary artery shunt versus modified Blalock-Taussig shunt in the Norwood procedure for hypoplastic left heart syndrome – influence on early and late haemodynamic status

• Published in: European journal of cardio-thoracic surgery 2003-05, Vol.23 (5), p.728-734
• Main Authors: Malec, Edward, Januszewska, Katarzyna, Kolcz, Jacek, Mroczek, Tomasz
• Format: Article
• Language: English
• Subjects: Anastomosis, Surgical; Blood Pressure - physiology; Female; Haemodynamic status; Heart Rate - physiology; Heart Ventricles - surgery; Humans; Hypoplastic left heart syndrome; Hypoplastic Left Heart Syndrome - physiopathology; Hypoplastic Left Heart Syndrome - surgery; Infant; Infant, Newborn; Male; Norwood procedure; Pulmonary Artery - surgery
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(03)00072-1

Objective: The aim of this study was to assess changes in early and late haemodynamic status after the Norwood procedure (NP), caused by the implementation of right ventricle-to-pulmonary artery shunt (RV-PA). Methods: A consecutive series of 68 children with hypoplastic left heart syndrome underwent NP: Group 1 (n=31) with the application of a modified Blalock-Taussig shunt and Group 2 (n=37) with RV-PA. Haemodynamic data from the early postoperative period (72 h after the operation) and cardiac catheterisation data, as well as blood tests before the hemi-Fontan procedure (HF) were analysed. Univariate (χ2 test, Mann–Whitney's and Student's t-tests) and multiple regression analysis were carried out. Results: In Group 1, circulatory collapse requiring resuscitation occurred in 15 (48.4%) children, within 72 h after the procedure. The resuscitation was unsuccessful in nine (29%) cases. The operative mortality (30 days) was 35%. In Group 2, two (5%) children died within the early and two (5%) within the late postoperative period. The postoperative course in the remaining children from Group 2 was uneventful. In Group 2 there was a significantly higher mean diastolic pressure after NP (P