Current outcomes and risk factors for the Norwood procedure

Stasik, Chad N.; Goldberg, Caren S.; Bove, Edward L.; Devaney, Eric J.; Ohye, Richard G.

doi:10.1016/j.jtcvs.2005.09.030

Cited by 238 publications

(176 citation statements)

References 24 publications

(36 reference statements)

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“…10,23 Also, the classical staged palliation approach appears to have reached a stagnation point, 24 no further improvements being possible with the currently available technology, with recent cumulative early and interstage mortality of 5%---30% for standard-risk patients 25---27 but as high as 30%---50% in high-risk patients. 11,12 A recent Pediatric Heart Network-sponsored multicenter randomized trial compared the Norwood procedure with a modified BT shunt versus the Sano modification, 26 with the primary endpoint of death or transplantation at one year and the secondary endpoints of hospital course, RV function by echo, pulmonary artery size by angiography, unintended cardiovascular interventions, and serious adverse events and complications. This study failed to show clear superiority between any of the approaches in the long term.…”

Section: Discussionmentioning

confidence: 99%

The hybrid approach for palliation of hypoplastic left heart syndrome: Intermediate results of a single-center experience

Laranjo¹,

Costa²,

Freitas³

et al. 2015

Revista Portuguesa de Cardiologia

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Introduction: Hypoplastic left heart syndrome (HLHS) is a major cause of cardiac death during the first week of life. The hybrid approach is a reliable, reproducible treatment option for patients with HLHS. Herein we report our results using this approach, focusing on its efficacy, safety and late outcome. Methods: We reviewed prospectively collected data on patients treated for HLHS using a hybrid approach between July 2007 and September 2014. Results: Nine patients had a stage 1 hybrid procedure, with seven undergoing a comprehensive stage 2 procedure. One patient completed the Fontan procedure. Five patients underwent balloon atrial septostomy after the hybrid procedure; in three patients, a stent was placed across the atrial septum. There were three deaths: two early after the hybrid procedure and one early after stage two palliation. Overall survival was 66%. Conclusions: In our single-center series, the hybrid approach for HLHS yields intermediate results comparable to those of the Norwood strategy. The existence of dedicated teams for the diagnosis and management of these patients, preferably in high-volume centers, is of major importance in this condition.

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Section: Discussionmentioning

confidence: 99%

The hybrid approach for palliation of hypoplastic left heart syndrome: Intermediate results of a single-center experience

Laranjo¹,

Costa²,

Freitas³

et al. 2015

Revista Portuguesa de Cardiologia

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“…4,[8][9][10][11][12] Our report evaluated the risk for hospital mortality in infants born with major CHDs who were supported with intensive care. In all, 25 (26%) of the infants died before undergoing surgical procedures, similar to that reported in Fesslova et al 3 …”

Section: Discussionmentioning

confidence: 99%

The effect of late preterm birth on mortality of infants with major congenital heart defects

et al. 2011

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Objective: We evaluated the effect of late preterm delivery (34 to 36 weeks) on hospital mortality of infants with congenital heart defects (CHDs).Study Design: Retrospective record review of infants with major CHD born at or after to 34 weeks, cared for in a single tertiary perinatal center between 2002 and 2009. Factors associated with death before discharge from the hospital were ascertained using univariate and multivariate analyses.Result: Of the 753 infants with CHD, 117 were born at late preterm. Using logistic regression analysis, white race (OR; 95% CI) (0.60; 0.39 to 0.95), late preterm delivery (2.70; 1.69 to 4.33), and need for intubation in the delivery room (3.15; 1.92 to 5.17) were independently associated with hospital death. Conclusion:Late preterm birth of infants with major CHDs was independently associated with increased risk of hospital death compared with delivery at more mature gestational ages.

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“…The first stage is the Norwood procedure, performed during the early neonatal period, with the second stage occurring during mid-infancy. (Bove et al, 2004;Sano et al, 2004;Stasik et al, 2006) Although modifications to the Norwood procedure have been associated with a reduction in early mortality, there remains a significant attrition rate between the first and second stages. (Forbess, 2003) This group of patients could particularly benefit from additional monitoring and support following discharge from hospital.…”

Section: Evidence For Tele-homecare In Paediatric Cardiologymentioning

confidence: 99%