Acute interventions for stenosed right ventricle-pulmonary artery conduit following the right-sided modification of Norwood-Sano procedure.
Congenit Heart Dis
; 4(6): 433-9, 2009.
Article
em En
| MEDLINE
| ID: mdl-19925536
ABSTRACT
INTRODUCTION:
The Norwood stage 1 procedure was modified by Sano with right ventricle-pulmonary artery (RV-PA) conduit replacing BT shunt. In our institution, this has been further modified by placing the conduit from the RV outflow tract to the right side of the neo-aorta. PATIENTS ANDMETHODS:
Between April 2002 and October 2008, 227 modified Norwood procedures were performed. Eighteen had the Sano modification with the conduit to the left of the neo-aorta whereas 209 had the right-sided modification, which is the study population. A total of 18 (8.6%) patients presented with cyanosis due to conduit stenosis with median age 4 months and median weight 6.3 kg.RESULTS:
Twelve patients underwent transcatheter stent placement in stenosed RV-PA conduit. A total of 16 coronary stents were implanted in 12 patients with 4 patients each receiving 2 stents. The mean saturations increased from 60% to 74%. There was one late mortality which was non-procedure related. Five patients treated with surgical take down of the RV-PA conduit and creation of a cavo-pulmonary shunt, whilst one patient had replacement of RV-PA conduit. There were no early postoperative deaths. The mean saturations improved from 54% to 75%.CONCLUSIONS:
The RV-PA conduit stenosis is a life-threatening complication after the modified Norwood Stage I procedure. This may require urgent surgery to replace the conduit or to perform a cavo-pulmonary shunt but as an alternative, transcatheter stent placement can be used with equal effectiveness and with a low risk of complications. The catheter approach is less invasive and the results show that it is an excellent option to relieve the stenosis even in the right-sided RV-PA conduit.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Cateterismo Cardíaco
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Stents
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Síndrome do Coração Esquerdo Hipoplásico
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Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
Congenit Heart Dis
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Reino Unido