RESUMO
This article will detail Dr. James Tweddell's operative technique and considerations for 26 all three stages of SVP in patients with HLHS. This will include the Norwood Procedure with 27 Right-Ventricle-to-Pulmonary-Artery Conduit (Sano Modification), Bidirectional Glenn 28 (Superior Cavopulmonary Connection), and Extracardiac, Fenestrated Fontan Completion (Total 29 Cavopulmonary Connection). These techniques are the culmination of over 20 years of experience 30 and represent the final techniques he employed at both Children's Hospital of Wisconsin and 31 Cincinnati Children's Hospital Medical Center.
Assuntos
Técnica de Fontan , Síndrome do Coração Esquerdo Hipoplásico , Procedimentos de Norwood , Cuidados Paliativos , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Síndrome do Coração Esquerdo Hipoplásico/história , Humanos , Técnica de Fontan/história , Técnica de Fontan/métodos , Procedimentos de Norwood/história , História do Século XX , Resultado do Tratamento , História do Século XXI , Ventrículos do Coração/cirurgia , Ventrículos do Coração/anormalidadesAssuntos
Transplante de Coração/história , Síndrome do Coração Esquerdo Hipoplásico/história , Transplante Heterólogo/história , Transplante Homólogo/história , California , Dissidências e Disputas/história , História do Século XX , Humanos , Liderança , Meios de Comunicação de Massa/história , Opinião PúblicaRESUMO
Over the last quarter of a century, improvements in antenatal diagnosis, preoperative care, neonatal surgical techniques, arch reconstruction, cardiopulmonary bypass strategies, catheter-based interventions and postoperative care have all resulted in dramatic improvements in the outcomes of the Norwood procedure for palliation of hypoplastic left heart syndrome. One such modification of the Norwood procedure, consisting of a right ventricle to pulmonary artery conduit to supply pulmonary blood flow instead of the modified Blalock-Taussig shunt, has been reported by various institutions to contribute to these improved outcomes. This article evaluates the current status of right ventricle to pulmonary artery shunt modification of the Norwood procedure with special emphasis on its impact on early and interstage outcomes, as well as real and potential drawbacks of this modification.