A operação de Norwood modificada para tratamento da síndrome de hipoplasia do coração esquerdo

Fantini, Fernando Antônio; Filho, Bayard Gontijo; Martins, Cristiane Nunes; Lopes, Roberto Max; Heiden, Eliane; Vrandecic, Ektor; Vrandecic, Mário Osvaldo

doi:10.1590/s0102-76382004000100009

Cited by 11 publications

(12 citation statements)

References 6 publications

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“…A Brazilian study conducted by Fantini et al7 showed immediate survival (from surgery until hospital discharge) of 80%, and 60% after 1 year of follow-up, in accordance with the literature where 1 month survival is reported to be between 72% and 60% after 1 year, and 54% after 5 years.…”

Section: Discussionsupporting

confidence: 79%

“…Without treatment this syndrome is fatal in 100% of cases with 95% of patients dying during the first month of life. HLHS is the most frequent cause of death by cardiopathy during the first week of life 7. The etiology is still not well known, but it seems to be multifactorial involving the mother, the gestation, the genetics, and exposure to teratogenic agents 6 , 8…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Classic form of hypoplastic left heart syndrome diagnosed post-natally: an autopsy report

Ferreira¹,

Aiello²,

Melo³

et al. 2014

ACR

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Hypoplastic left heart syndrome (HLHS) is a congenital heart disease, which, despite the current improved knowledge about its management and surgical treatment, is still associated with high mortality, especially in the early neonatal period and before the second stage of reconstruction surgery. The low rate of prenatal diagnosis and delayed diagnostic suspicion results in unsuccessful therapeutic intervention, even though the real impact of early diagnosis and intervention on mortality and quality of life of patients is still uncertain. Fortunately, this syndrome of challenging treatment is not that frequent. It involves a spectrum of obstructions to the blood flow within the left heart and is characterized by an inappropriate size of the left ventricle associated with a wide variety of valvular dysfunctions. Treatment ranges from heart transplantation to palliative surgical procedures. The authors describe a case of a newborn with HLHS, whose diagnosis was made after birth because of early respiratory failure. Despite the use of prostaglandin the newborn died. An autopsy was performed and the anatomical findings were described.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Classic form of hypoplastic left heart syndrome diagnosed post-natally: an autopsy report

Ferreira¹,

Aiello²,

Melo³

et al. 2014

ACR

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“…The Norwood procedure is often performed using CPB associated with total circulatory arrest with deep hypothermia [14]. This procedure is not free of neurological complications and may increase the incidence of seizures during the immediate postoperative period and may cause delayed psychomotor development.…”

Section: Discussionmentioning

confidence: 99%

Nova técnica: operação de Norwood com perfusão regional cerebral e coronariana

Furlanetto¹,

Furlanetto²,

Henriques³

et al. 2009

Rev Bras Cir Cardiovasc

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Objective: To assess the immediate result of the modified Norwood procedure with new technique of anterograde regional cerebral perfusion (rACP) and retrograde regional coronary perfusion (rRCorP) in substitution of profound hypothermia and circulatory arrest in children with hypoplastic left heart syndrome (HLHS) with extremely hypoplastic ascending aorta (HA).Methods: In the period of December of 2006 to February 2008 the modified Norwood procedure with tube between the right ventricle and pulmonary arteries or Sano shunt was performed in eight children with HLHS and with ascending aorta diameter less than 3 mm, (four male and four female) with median age of 9.2 days (ranging from 1 to 29 days) and median weigh of 3.3 kg (ranging from 2.7 to 3.8 kg). We used cardiopulmonary bypass and hypothermia at 25°C with two venous cannulas and suture with a polytetrafluoroethylene graft sutured to the innominate artery as an arterial line and used to ARCeP. The RRCoP was performed by a deviation in the arterial line and placement of a catheter in the ascending aorta. The immediate surgical results and the clinical neurological manifestation were assessed. Results: The immediate surgical results revealed mortality of 25% and there were absence of neurological injury at clinical examination. Conclusions:The modified Norwood procedure can be accomplished with ARCeP and RRCoP in children with HLHS with HA with satisfactory immediate surgical result and without neurological complications.Descriptors: Hypoplastic left heart syndrome. Heart defects, congenital/surgery. Cardiac surgical procedures. Extracorporeal circulation/methods.

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“…In the national literature, there was an early death in a series of five children submitted to the Norwood procedure from January to December of 2002, excluding those children with an aorta smaller than 4 mm or with severe infections. The Glenn procedure was performed in 1 ten-month-old infant so the mortality after the first stage was 25% (one case after 2 months) [24].…”

Section: Commentsmentioning

confidence: 99%

<![CDATA[<B>Bidirectional Glenn procedure in the staged treatment of hypoplastic left heart syndrome</B>: <B>early and late results</B>]]>

Fonseca¹,

Silva²,

Franchi³

et al. 2005

Braz. j. cardiovasc. surg.

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Objective: To report early and long-term results of bidirectional Glenn procedure as the second stage for Hypoplastic Left Heart Syndrome (HLHS) treatment and describe a ministernotomy technique. Method: From March 1998 to February 2004, 15 patients who had been previously submitted to the Norwood procedure underwent elective partial cavopulmonary anastomosis. Ages ranged from 2 to 6 months (mean 3.46 ± 0.83 months). Six were male. Ministernotomy was performed in 11 (73.3%) patients. In order to obtain adequate initial blood oxygenation, an accessory 3-mm PTFE shunt was used in 9 patients and the right ventricle-pulmonary artery tube was maintained in one case. Clinical and echocardiographic follow-up was obtained in all patients. Results: Hospital survival was 86.6%, with one early death caused by surgical bleeding and another due to hypoxemia. Postoperative echocardiogram showed some early blood flow in the PTFE shunt and its closure in the long-term follow-up. There were two late deaths, one due to tracheostomy complications and another due to infectious meningitis. Seven patients, who are waiting for the third stage, are doing well clinically. Four patients have already undergone the third stage, successfully. The echocardiograms of 11 late survival patients showed good right ventricular function, no tricuspid regurgitation and good cavopulmonary blood flow over a 2.5-year mean follow-up time. Conclusions: The Glenn procedure in HLHS resulted in a low mortality rate and satisfactory long-term outcomes, and can be performed using the ministernotomy technique. An accessory source of systemic-pulmonary flow in very small infants seems to improve the oxygen saturation.

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A operação de Norwood modificada para tratamento da síndrome de hipoplasia do coração esquerdo

Cited by 11 publications

References 6 publications

Classic form of hypoplastic left heart syndrome diagnosed post-natally: an autopsy report

Classic form of hypoplastic left heart syndrome diagnosed post-natally: an autopsy report

Nova técnica: operação de Norwood com perfusão regional cerebral e coronariana

<![CDATA[<B>Bidirectional Glenn procedure in the staged treatment of hypoplastic left heart syndrome</B>: <B>early and late results</B>]]>

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