Síndrome do coração esquerdo hipoplásico: estratégia cirúrgica e comparação de resultados com técnicas de Norwood x Sano

Silva, José Pedro da; Fonseca, Luciana da; Baumgratz, José Francisco; Castro, Rodrigo Moreira; Franchi, Sônia Meiken; Lianza, Alessandro Cavalcante; Vila, José Henrique Andrade

doi:10.1590/s0102-76382007000200003

Cited by 14 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Even today, HLHS remains one of the most challenging pathologies among congenital heart diseases. Despite of the recent data reflecting a continuous improvement of the outcomes in the world's best centers of pediatric cardiology, the mortality rate is still high, especially in less experienced institutions [ 10 ] .…”

Section: Discussionmentioning

confidence: 99%

Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil

Faria¹,

Pacheco

Oliveira

et al. 2017

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

IntroductionAlthough it only corresponds to 2.5% of congenital heart defects, hypoplastic left heart syndrome (HLHS) is responsible for more than 25% of cardiac deaths in the first week of life. Palliative surgery performed after the second week of life is considered an important risk factor in the treatment of HLHS.ObjectiveThe aim of this study is to describe the initial experience of a medical center in Northeastern Brazil with a modified off-pump hybrid approach for palliation of HLHS.MethodsFrom November 2012 through November 2015, the medical records of 8 patients with HLHS undergoing hybrid procedure were retrospectively evaluated in a tertiary private hospital in Northeastern Brazil. The modified off-pump hybrid palliation consisted of stenting of the ductus arteriosus guided by fluoroscopy without contrast and banding of the main pulmonary artery branches. Demographic and clinical variables were recorded for descriptive analysis.ResultsEight patients were included in this study, of whom 37.5% were female. The median age and weight at the time of the procedure was 2 days (p25% and p75% = 2 and 4.5 days, respectively) and 3150 g (p25% and p75% = 3077.5 g and 3400 g, respectively), respectively. The median length in intensive care unit stay was 6 days (p25% and p75% = 3.5% and 8 days, respectively). There were no in-hospital deaths. Four patients have undergone to the second stage of the surgical treatment of HLHS.ConclusionIn this series, the initial experience with the modified off-pump hybrid procedure showed to be safe, allowing a low early mortality rate among children presenting HLHS.

show abstract

Section: Discussionmentioning

confidence: 99%

Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil

Faria¹,

Pacheco

Oliveira

et al. 2017

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…Brazil has reference centers with almost 30 years of experience and successful reports of the Norwood surgery and increasing advances in hybrid procedures and postoperative care, with results comparable to the best centers in the world [29][30][31][32] . Nonetheless, the qualified services are mainly concentrated in the Southeast and South regions, being of difficult access for most cases from other regions of the country.…”

Section: Hlhs Challenges In Brazil -From Diagnosis To Treamentmentioning

confidence: 95%

The care of the patients with hipoplastic left heart syndrome in places of social and economic vulneability. An ethical analysis

ROCHA

FONSECA

Silva

2023

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

The birth of a child means hope and joy, particularly for the parents and the healthcare team. When this child is born with a severe malformation and a poor prognosis, as in the case of hypoplastic left heart syndrome, the scenario is one of great uncertainty and emotional suffering. The role of the health team becomes fundamental for the identification of conflicts of values and for the search for shared decisions that promote the best benefit to the child. When the diagnosis is made during fetal life, it is necessary to develop counseling strategies appropriate to the context of each family. In places with limited care resources, precarious prenatal care and short temporal conditions, the recommended counseling is compromised. Indication of treatment requires technical competence and a detailed analysis of ethical issues, and consultation with institutional clinical bioethics services or commissions is important. The article proposes to address the moral conflicts of two clinical cases and the respective bioethical analysis that involves principles and values in contexts of vulnerability and uncertainty, contrasting two situations where the indication of treatment was based on accessibility to treatment.

show abstract

“…Although the HLHS is extensively studied, the surgical treatment performed by the Norwood-type palliative surgery [3][4] or by the so-called hybrid procedures [5][6] has satisfactory results in many centers [7][8]. Nevertheless, this disease still has a high mortality rate between the first and second stage, when compared to other diseases treated as univentricular physiology.…”

Section: Introductionmentioning

confidence: 99%

Dominância coronariana na síndrome da hipoplasia do coração esquerdo

Abuchaim¹,

Tanamati²,

Jatene³

et al. 2011

Rev Bras Cir Cardiovasc

View full text Add to dashboard Cite

Introduction: Although hypoplastic left heart syndrome (HLHS) is extensively studied this disease still has a high mortality rate compared to other diseases treated as univentricular physiology. In this context, morphological differences between phenotypes within the spectrum of HLHS may be recognized as risk factors, and their identification can assist in choosing treatment between subgroups.Objective: To identify the most prevalent form of coronary artery dominance in HLHS in subgroups with atresia and mitral stenosis.Methods: Analysis of the coronary anatomy according to the distribution of epicardial branches and the dominance patterns classified as right, left, or balanced (co-dominant). Control group was composed of nine specimens of morphologically normal hearts; the HLHS group consisted of nine specimens with MA and 24 specimens with MS. We applied Chi-square test for statistical analysis.Results: There were significant differences between the two groups in relation to coronary artery dominance (÷2 = 9.298; P = 0.01). Left dominance was present in 75% of MS cases and the balanced (co-dominant) dominance was observed only in MS. In the control group, right dominance was observed in all cases (P <0.01).Conclusions: Left dominance is more common in HLHS than in the control group of normal hearts and in HLHS. The left coronary dominance is more frequent in the subgroup with mitral stenosis.Descriptors: Heart/anatomy & histology. Coronary vessels. Hypoplastic left heart syndrome. Heart defects, congenital. Rev Bras Cir Cardiovasc 2011;26(4):604-8 Resumo

show abstract

Síndrome do coração esquerdo hipoplásico: estratégia cirúrgica e comparação de resultados com técnicas de Norwood x Sano

Cited by 14 publications

References 29 publications

Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil

Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil

The care of the patients with hipoplastic left heart syndrome in places of social and economic vulneability. An ethical analysis

Dominância coronariana na síndrome da hipoplasia do coração esquerdo

Contact Info

Product

Resources

About