Midterm ventricular performance after norwood procedure with right ventricular-pulmonary artery conduit

Yoshihisa Tanoue, Hideaki Kado, Yuichi Shiokawa, Naoki Fusazaki, Shiro Ishikawa

Research output: Contribution to journalArticle

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Abstract

Midterm and long-term results of patients who underwent a Norwood procedure with a right ventricular-pulmonary artery conduit remain unclear. This study aimed to compare the midterm ventricular performance of the Norwood procedure with right ventricular-pulmonary artery conduit and the Norwood procedure with systemic-pulmonary shunt. Twenty-one patients who underwent both a bidirectional Glenn procedure and a total cavopulmonary connection after Norwood palliation at Fukuoka Children's Hospital Medical Center were divided into two groups: the systemic-pulmonary shunt group (n = 11) and the right ventricular-pulmonary artery conduit group (n = 10). End-systolic elastance (contractility), effective arterial elastance (afterload), and ventriculoarterial coupling and the ratio of stroke work and pressure-volume area (ventricular efficiency) were measured on the basis of cardiac catheterization data before the bidirectional Glenn procedure, before and after the total cavopulmonary connection, and at approximately 1 year after total cavopulmonary connection. After bidirectional Glenn procedure and total cavopulmonary connection, end-systolic elastance of the right ventricular-pulmonary artery conduit group was lower than that of the systemic-pulmonary shunt group, whereas effective arterial elastance of the right ventricular-pulmonary artery conduit group was lower than that of the systemic-pulmonary shunt group. Consequently, there was no difference in ventricular efficiency in both groups 1 year after total cavopulmonary connection. The midterm ventricular performance of the right ventricular-pulmonary artery conduit group was comparable with the systemic-pulmonary shunt group in terms of ventricular efficiency. However, after bidirectional Glenn procedure and total cavopulmonary connection, contractility in patients who underwent a Norwood procedure with a right ventricular-pulmonary artery conduit was inferior to that of patients who underwent a Norwood procedure with a systemic-pulmonary shunt.

Original languageEnglish
Pages (from-to)1965-1971
Number of pages7
JournalAnnals of Thoracic Surgery
Volume78
Issue number6
DOIs
Publication statusPublished - Dec 1 2004

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Norwood Procedures
Pulmonary Artery
Fontan Procedure
Lung
Cardiac Catheterization
Stroke
Pressure

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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Midterm ventricular performance after norwood procedure with right ventricular-pulmonary artery conduit. / Tanoue, Yoshihisa; Kado, Hideaki; Shiokawa, Yuichi; Fusazaki, Naoki; Ishikawa, Shiro.

In: Annals of Thoracic Surgery, Vol. 78, No. 6, 01.12.2004, p. 1965-1971.

Research output: Contribution to journalArticle

Tanoue, Yoshihisa ; Kado, Hideaki ; Shiokawa, Yuichi ; Fusazaki, Naoki ; Ishikawa, Shiro. / Midterm ventricular performance after norwood procedure with right ventricular-pulmonary artery conduit. In: Annals of Thoracic Surgery. 2004 ; Vol. 78, No. 6. pp. 1965-1971.
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abstract = "Midterm and long-term results of patients who underwent a Norwood procedure with a right ventricular-pulmonary artery conduit remain unclear. This study aimed to compare the midterm ventricular performance of the Norwood procedure with right ventricular-pulmonary artery conduit and the Norwood procedure with systemic-pulmonary shunt. Twenty-one patients who underwent both a bidirectional Glenn procedure and a total cavopulmonary connection after Norwood palliation at Fukuoka Children's Hospital Medical Center were divided into two groups: the systemic-pulmonary shunt group (n = 11) and the right ventricular-pulmonary artery conduit group (n = 10). End-systolic elastance (contractility), effective arterial elastance (afterload), and ventriculoarterial coupling and the ratio of stroke work and pressure-volume area (ventricular efficiency) were measured on the basis of cardiac catheterization data before the bidirectional Glenn procedure, before and after the total cavopulmonary connection, and at approximately 1 year after total cavopulmonary connection. After bidirectional Glenn procedure and total cavopulmonary connection, end-systolic elastance of the right ventricular-pulmonary artery conduit group was lower than that of the systemic-pulmonary shunt group, whereas effective arterial elastance of the right ventricular-pulmonary artery conduit group was lower than that of the systemic-pulmonary shunt group. Consequently, there was no difference in ventricular efficiency in both groups 1 year after total cavopulmonary connection. The midterm ventricular performance of the right ventricular-pulmonary artery conduit group was comparable with the systemic-pulmonary shunt group in terms of ventricular efficiency. However, after bidirectional Glenn procedure and total cavopulmonary connection, contractility in patients who underwent a Norwood procedure with a right ventricular-pulmonary artery conduit was inferior to that of patients who underwent a Norwood procedure with a systemic-pulmonary shunt.",
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