Single ventricle physiology: surgical options, indications and outcomes

Jaquiss, Robert D.B.; Imamura, Michiaki

doi:10.1097/hco.0b013e328323d85a

Cited by 24 publications

(29 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is particularly true for lesions with single ventricle physiology, in which only one anatomical or functional ventricular chamber pumps blood to the pulmonary and systemic vascular beds [4] (Table 1). These lesions require staged procedures to be converted into serial circulation where the ventricle pumps blood to the systemic circuit, whereas only pulmonary blood flow (PBF) occurs without a dedicated ventricle.…”

Section: Introductionmentioning

confidence: 98%

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

2011

View full text Add to dashboard Cite

Patients with congenital heart diseases are a growing population, and noncardiac surgeries will become an important health care issue. Patients with single ventricle physiology are a particularly challenging population who will undergo staged, palliative repair toward a final step of Fontan circulation. Although Fontan surgery creates a serial circulation in which the ventricle pumps blood to the systemic circuit, pulmonary blood flow occurs without a dedicated ventricle. Despite progress in outcomes, this abnormal circulation remains associated with various co-morbidities such as ventricular dysfunction, arrhythmias, protein losing enteropathy, and plastic bronchitis. Health care professionals must prepare for these patients to present to noncardiac surgery at any stage of intervention, possibly with complications. Given that staged, palliative repair has undergone multiple modifications, patients who present for surgery can vary in types and timing of the repair. Anesthesiologists who care for them must be familiar with perioperative issues to optimize outcomes, especially because congenital heart disease is a risk factor for increased mortality for noncardiac surgery.

show abstract

Section: Introductionmentioning

confidence: 98%

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

2011

View full text Add to dashboard Cite

show abstract

“…In einem 2009 von einer kanadischen Arbeitsgruppe veröffentlichten Über sichtsartikel wurde der Schluss gezogen, dass es aufgrund der Entwicklung ei ner Vielzahl operativer Techniken, kom biniert mit einem besseren Verständnis der komplexen Physiologie, zu einer si gnifikanten Verbesserung der Progno se, aber auch der Lebensqualität kommt [3]. Dies deckt sich weitgehend mit den Erfahrungen an unserem Zentrum.…”

Section: Abb 3 9 Ergebnis Der Extrakardialen Fenestrierten Fontanopeunclassified

“…Ob diese Untersuchung durch eine Darstellung im MRT (Magnetreso nanztomographie) -eine natürlich we sentlich weniger invasive Methode -ab gelöst werden wird, ist derzeit Inhalt wis senschaftlicher Diskurse[11].Aufgrund der Tatsache, dass die Palliati on des HLHS erst in den letzten 20 Jah ren möglich wurde, und sowohl die Pati enten als auch die operativen Prozeduren divergieren, ist es schwer möglich, wissen schaftlich exakte Daten zu erheben, die gut vergleichbar sind. Eine Vielzahl von rezenten Publikationen befasste sich mit Teilaspekten der Palliation[3,5,10,14].Bedenken sollte man auch, dass das HLHS kombiniert mit anderen Fehlbil dungen und Chromosomenaberrationen vorkommt. Im eigenen Patientengut[9] fanden wir bei 51% extrakardiale Anoma lien und bei 7,5% Chromosomenaberratio nen.…”

unclassified

Hypoplastisches Linksherzsyndrom

Weinzettel

Mair

Tulzer

et al. 2010

Monatsschr Kinderheilkd

View full text Add to dashboard Cite

Von der pränatalen Diagnose bis zum SchulalterLeitthema Die Diagnose des hypoplastischen Linksherzsyndroms (HLHS) war bis zur Etablierung der Norwood-Operation in den 1980er Jahren infaust. Heutzutage erfolgt die Versorgung in mehreren operativen Schritten, zunächst der Norwood-und GlennOperation oder einem Hybridverfahren aus beiden, sowie im weiteren Verlauf der Fontan-Operation. Eine pränatale Diagnose erleichtert das perinatale Management und die prä-operative Phase wesentlich. Im vorliegenden Beitrag werden das HLHS und die Möglichkeiten seiner Behandlung, insbesondere die operativen Verfahren sowie das Outcome dargestellt.

show abstract

“…A significant development in the management of congenital heart disease (CHD) has been the advent and refinement of staged surgical palliation for patients with single ventricle defects [4,10]. The conduct of staged palliation has evolved during recent decades, with most centers currently performing an intermediary superior cavopulmonary connection (SCPC) before Fontan surgery as a means of relieving both cyanosis and the volume load imposed on the systemic ventricle [5].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Infants Undergoing Superior Cavopulmonary Connection in the Presence of Ventricular Dysfunction

et al. 2011

View full text Add to dashboard Cite

Outcomes in patients with ventricular dysfunction undergoing superior cavopulmonary connection (SCPC) are not well known. We reviewed records of patients undergoing SCPC at our center from December 2005 to October 2009 and studied those whose pre-SCPC echocardiograms demonstrated at least moderate systemic ventricular dysfunction. Of the 213 patients undergoing SCPC, 19 (9%) met inclusion criteria. Diagnoses were hypoplastic left heart syndrome (n = 18) and rightward unbalanced atrioventricular canal with pulmonary stenosis (n = 1). In those surviving >2 months after SCPC, ventricular function was assessed by echocardiography 4.9 (range 3.5 to 9.7) months after SCPC and was improved in ten of 17 (59%), unchanged in six of 17 (35%), and worsened in one of 17 (16%) patients. After SCPC, three patients died, and one underwent heart transplant 21.9 months after SCPC. Transplant-free survival was attained by 15 of 19 (79%) patients during follow-up of 33.0 months (range 10.8 to 51.4). Fontan completion was performed on six survivors on reaching an appropriate age. Ventricular dysfunction before SCPC is not uncommon and occurs primarily in patients with a morphologic right ventricle. Ventricular performance improves in the majority of patients after SCPC, and midterm outcomes are comparable with previous reports, suggesting that these patients remain candidates for staged palliation.

show abstract

Single ventricle physiology: surgical options, indications and outcomes

Abstract: Advances in the care of children with single ventricle hearts have resulted in remarkably improved prognosis, with the expectation of continued improvement in not only survival but also quality of life.

Cited by 24 publications

References 55 publications

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

Hypoplastisches Linksherzsyndrom

Outcomes of Infants Undergoing Superior Cavopulmonary Connection in the Presence of Ventricular Dysfunction

Contact Info

Product

Resources

About