[Surgical strategy and the results for hypoplastic left heart syndrome]

Toshihide Nakano, Hideaki Kado, Hideki Tatewaki, Kazuhiro Hinokiyama, Daisuke Machida, Noriyoshi Ebuoka, Takahiro Shoujima, Jin Ikarashi

Research output: Contribution to journalArticle

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Abstract

METHODS: Seventy-seven patients with classic HLHS were involved in this study. For the initial palliation, 23 patients underwent Norwood operation with modified Blalock-Taussig (BT) shunt, 23 patients underwent Norwood operation with right ventricle to pulmonary artery( RV-PA) shunt and 31 patients underwent bilateral pulmonary artery banding (BPAB). Surgical results, freedom from Fontan operation, hemodynamic data and incidence of complication after Fontan operation were compared between the 3 groups.

RESULTS: BPAB group had more preoperative risk factors than Norwood group. Total actuarial survival was 62.4% at 1 year and 58.2% at 3 and 5 years, and there was no difference between the groups. Freedom from Fontan completion was 59.4% at 3 years and 48.7% at 5 years without difference between the groups. The incidence of intervention for pulmonary artery stenosis was higher in Norwood with RV-PA shunt group(52.9%). Hemodynamic data obtained by cardiac catheterization were similar in the 3 groups, however, end-systolic elastance, which represents ventricular contractility, was lower in Norwood with RV-PA group.

CONCLUSIONS: Surgical results of Norwood with BT shunt and Norwood with RV-PA shunt were comparably satisfactory, however, there was possible concern of reduced ventricular contractility in RV-PA shunt group. BPAB was a effective and useful initial palliation in high risk cases.

OBJECTIVE: We retrospectively reviewed our surgical results in patients with hypoplastic left heart syndrome( HLHS) to investigate the influence of surgical strategy on outcome.

Original languageEnglish
Pages (from-to)299-304
Number of pages6
JournalKyobu geka. The Japanese journal of thoracic surgery
Volume67
Issue number4
Publication statusPublished - Apr 1 2014

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Hypoplastic Left Heart Syndrome
Pulmonary Artery
Heart Ventricles
Norwood Procedures
Blalock-Taussig Procedure
Fontan Procedure
Hemodynamics
Incidence
Cardiac Catheterization
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Nakano, T., Kado, H., Tatewaki, H., Hinokiyama, K., Machida, D., Ebuoka, N., ... Ikarashi, J. (2014). [Surgical strategy and the results for hypoplastic left heart syndrome]. Kyobu geka. The Japanese journal of thoracic surgery, 67(4), 299-304.

[Surgical strategy and the results for hypoplastic left heart syndrome]. / Nakano, Toshihide; Kado, Hideaki; Tatewaki, Hideki; Hinokiyama, Kazuhiro; Machida, Daisuke; Ebuoka, Noriyoshi; Shoujima, Takahiro; Ikarashi, Jin.

In: Kyobu geka. The Japanese journal of thoracic surgery, Vol. 67, No. 4, 01.04.2014, p. 299-304.

Research output: Contribution to journalArticle

Nakano, T, Kado, H, Tatewaki, H, Hinokiyama, K, Machida, D, Ebuoka, N, Shoujima, T & Ikarashi, J 2014, '[Surgical strategy and the results for hypoplastic left heart syndrome]', Kyobu geka. The Japanese journal of thoracic surgery, vol. 67, no. 4, pp. 299-304.
Nakano, Toshihide ; Kado, Hideaki ; Tatewaki, Hideki ; Hinokiyama, Kazuhiro ; Machida, Daisuke ; Ebuoka, Noriyoshi ; Shoujima, Takahiro ; Ikarashi, Jin. / [Surgical strategy and the results for hypoplastic left heart syndrome]. In: Kyobu geka. The Japanese journal of thoracic surgery. 2014 ; Vol. 67, No. 4. pp. 299-304.
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AU - Machida, Daisuke

AU - Ebuoka, Noriyoshi

AU - Shoujima, Takahiro

AU - Ikarashi, Jin

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N2 - METHODS: Seventy-seven patients with classic HLHS were involved in this study. For the initial palliation, 23 patients underwent Norwood operation with modified Blalock-Taussig (BT) shunt, 23 patients underwent Norwood operation with right ventricle to pulmonary artery( RV-PA) shunt and 31 patients underwent bilateral pulmonary artery banding (BPAB). Surgical results, freedom from Fontan operation, hemodynamic data and incidence of complication after Fontan operation were compared between the 3 groups.RESULTS: BPAB group had more preoperative risk factors than Norwood group. Total actuarial survival was 62.4% at 1 year and 58.2% at 3 and 5 years, and there was no difference between the groups. Freedom from Fontan completion was 59.4% at 3 years and 48.7% at 5 years without difference between the groups. The incidence of intervention for pulmonary artery stenosis was higher in Norwood with RV-PA shunt group(52.9%). Hemodynamic data obtained by cardiac catheterization were similar in the 3 groups, however, end-systolic elastance, which represents ventricular contractility, was lower in Norwood with RV-PA group.CONCLUSIONS: Surgical results of Norwood with BT shunt and Norwood with RV-PA shunt were comparably satisfactory, however, there was possible concern of reduced ventricular contractility in RV-PA shunt group. BPAB was a effective and useful initial palliation in high risk cases.OBJECTIVE: We retrospectively reviewed our surgical results in patients with hypoplastic left heart syndrome( HLHS) to investigate the influence of surgical strategy on outcome.

AB - METHODS: Seventy-seven patients with classic HLHS were involved in this study. For the initial palliation, 23 patients underwent Norwood operation with modified Blalock-Taussig (BT) shunt, 23 patients underwent Norwood operation with right ventricle to pulmonary artery( RV-PA) shunt and 31 patients underwent bilateral pulmonary artery banding (BPAB). Surgical results, freedom from Fontan operation, hemodynamic data and incidence of complication after Fontan operation were compared between the 3 groups.RESULTS: BPAB group had more preoperative risk factors than Norwood group. Total actuarial survival was 62.4% at 1 year and 58.2% at 3 and 5 years, and there was no difference between the groups. Freedom from Fontan completion was 59.4% at 3 years and 48.7% at 5 years without difference between the groups. The incidence of intervention for pulmonary artery stenosis was higher in Norwood with RV-PA shunt group(52.9%). Hemodynamic data obtained by cardiac catheterization were similar in the 3 groups, however, end-systolic elastance, which represents ventricular contractility, was lower in Norwood with RV-PA group.CONCLUSIONS: Surgical results of Norwood with BT shunt and Norwood with RV-PA shunt were comparably satisfactory, however, there was possible concern of reduced ventricular contractility in RV-PA shunt group. BPAB was a effective and useful initial palliation in high risk cases.OBJECTIVE: We retrospectively reviewed our surgical results in patients with hypoplastic left heart syndrome( HLHS) to investigate the influence of surgical strategy on outcome.

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