Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome

Takahisa Sakurai, Hideaki Kado, Toshihide Nakano, Kazuhiro Hinokiyama, Akira Shiose, Masaki Kajimoto, Kunihiko Joo, Yuichi Ueda

研究成果: ジャーナルへの寄稿記事

27 引用 (Scopus)

抄録

Objective: To compare the haemodynamics and perioperative course of initial palliation with bilateral pulmonary artery banding (PAB) and the Norwood procedure. Methods: Between April 2004 and December 2007, 43 consecutive children with hypoplastic left heart syndrome (HLHS) or a variant underwent initial palliation (PAB, n = 18; Norwood, n = 25). Clinical perioperative data were analysed. In the PAB group, lipo-prostaglandin E1 administration was continued with hospitalisation until stage 2 palliation with a bi-directional Glenn shunt and the Norwood procedure. Results: There were no significant differences in the age and operative weight of patients who received stage 1 palliation (PAB, 12 ± 9 days, 2.7 ± 0.6 kg; Norwood, 12 ± 8 days, 2.8 ± 0.4 kg). The PAB group had more high-risk patients than the Norwood group (PAB, 83%; Norwood, 48%, p = 0.04). Increased early and inter-stage mortality were observed in patients who underwent the Norwood procedure (early mortality with PAB, 6% vs Norwood, 12%; inter-stage mortality, 6% vs 27%, respectively). Mortality between stages 1 and 2 was 11% for the PAB group and 36% for the Norwood group. The Kaplan-Meier survival estimate at 1 year did not differ between groups (77% for the PAB group, 64% for the Norwood group). Ductal stenosis was found in one patient in the PAB group during the follow-up period. Twenty-eight patients underwent stage 2 reconstruction, and the patients in the PAB group were younger at the time of surgery (PAB, 116 days; Norwood, 224 days). There were no significant differences between groups in pulmonary artery index regarding body surface area (BSA) (PAB, 179 mm2 BSA-1; Norwood, 194 mm2 BSA-1) and the incidence of ventricular dysfunction after stage 2 construction (PAB, 21%; Norwood, 21%). Conclusions: Bilateral PAB with continuous lipo-prostaglandin E1 administration may improve early and intermediate mortality in infants with HLHS. Intimate care with hospitalisation may contribute to the results.

元の言語英語
ページ(範囲)973-979
ページ数7
ジャーナルEuropean Journal of Cardio-thoracic Surgery
36
発行部数6
DOI
出版物ステータス出版済み - 12 1 2009

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Hypoplastic Left Heart Syndrome
Pulmonary Artery
Norwood Procedures
Body Surface Area
Mortality
Alprostadil
Hospitalization
Ventricular Dysfunction

All Science Journal Classification (ASJC) codes

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

これを引用

Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome. / Sakurai, Takahisa; Kado, Hideaki; Nakano, Toshihide; Hinokiyama, Kazuhiro; Shiose, Akira; Kajimoto, Masaki; Joo, Kunihiko; Ueda, Yuichi.

:: European Journal of Cardio-thoracic Surgery, 巻 36, 番号 6, 01.12.2009, p. 973-979.

研究成果: ジャーナルへの寄稿記事

Sakurai, Takahisa ; Kado, Hideaki ; Nakano, Toshihide ; Hinokiyama, Kazuhiro ; Shiose, Akira ; Kajimoto, Masaki ; Joo, Kunihiko ; Ueda, Yuichi. / Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome. :: European Journal of Cardio-thoracic Surgery. 2009 ; 巻 36, 番号 6. pp. 973-979.
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abstract = "Objective: To compare the haemodynamics and perioperative course of initial palliation with bilateral pulmonary artery banding (PAB) and the Norwood procedure. Methods: Between April 2004 and December 2007, 43 consecutive children with hypoplastic left heart syndrome (HLHS) or a variant underwent initial palliation (PAB, n = 18; Norwood, n = 25). Clinical perioperative data were analysed. In the PAB group, lipo-prostaglandin E1 administration was continued with hospitalisation until stage 2 palliation with a bi-directional Glenn shunt and the Norwood procedure. Results: There were no significant differences in the age and operative weight of patients who received stage 1 palliation (PAB, 12 ± 9 days, 2.7 ± 0.6 kg; Norwood, 12 ± 8 days, 2.8 ± 0.4 kg). The PAB group had more high-risk patients than the Norwood group (PAB, 83{\%}; Norwood, 48{\%}, p = 0.04). Increased early and inter-stage mortality were observed in patients who underwent the Norwood procedure (early mortality with PAB, 6{\%} vs Norwood, 12{\%}; inter-stage mortality, 6{\%} vs 27{\%}, respectively). Mortality between stages 1 and 2 was 11{\%} for the PAB group and 36{\%} for the Norwood group. The Kaplan-Meier survival estimate at 1 year did not differ between groups (77{\%} for the PAB group, 64{\%} for the Norwood group). Ductal stenosis was found in one patient in the PAB group during the follow-up period. Twenty-eight patients underwent stage 2 reconstruction, and the patients in the PAB group were younger at the time of surgery (PAB, 116 days; Norwood, 224 days). There were no significant differences between groups in pulmonary artery index regarding body surface area (BSA) (PAB, 179 mm2 BSA-1; Norwood, 194 mm2 BSA-1) and the incidence of ventricular dysfunction after stage 2 construction (PAB, 21{\%}; Norwood, 21{\%}). Conclusions: Bilateral PAB with continuous lipo-prostaglandin E1 administration may improve early and intermediate mortality in infants with HLHS. Intimate care with hospitalisation may contribute to the results.",
author = "Takahisa Sakurai and Hideaki Kado and Toshihide Nakano and Kazuhiro Hinokiyama and Akira Shiose and Masaki Kajimoto and Kunihiko Joo and Yuichi Ueda",
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T1 - Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome

AU - Sakurai, Takahisa

AU - Kado, Hideaki

AU - Nakano, Toshihide

AU - Hinokiyama, Kazuhiro

AU - Shiose, Akira

AU - Kajimoto, Masaki

AU - Joo, Kunihiko

AU - Ueda, Yuichi

PY - 2009/12/1

Y1 - 2009/12/1

N2 - Objective: To compare the haemodynamics and perioperative course of initial palliation with bilateral pulmonary artery banding (PAB) and the Norwood procedure. Methods: Between April 2004 and December 2007, 43 consecutive children with hypoplastic left heart syndrome (HLHS) or a variant underwent initial palliation (PAB, n = 18; Norwood, n = 25). Clinical perioperative data were analysed. In the PAB group, lipo-prostaglandin E1 administration was continued with hospitalisation until stage 2 palliation with a bi-directional Glenn shunt and the Norwood procedure. Results: There were no significant differences in the age and operative weight of patients who received stage 1 palliation (PAB, 12 ± 9 days, 2.7 ± 0.6 kg; Norwood, 12 ± 8 days, 2.8 ± 0.4 kg). The PAB group had more high-risk patients than the Norwood group (PAB, 83%; Norwood, 48%, p = 0.04). Increased early and inter-stage mortality were observed in patients who underwent the Norwood procedure (early mortality with PAB, 6% vs Norwood, 12%; inter-stage mortality, 6% vs 27%, respectively). Mortality between stages 1 and 2 was 11% for the PAB group and 36% for the Norwood group. The Kaplan-Meier survival estimate at 1 year did not differ between groups (77% for the PAB group, 64% for the Norwood group). Ductal stenosis was found in one patient in the PAB group during the follow-up period. Twenty-eight patients underwent stage 2 reconstruction, and the patients in the PAB group were younger at the time of surgery (PAB, 116 days; Norwood, 224 days). There were no significant differences between groups in pulmonary artery index regarding body surface area (BSA) (PAB, 179 mm2 BSA-1; Norwood, 194 mm2 BSA-1) and the incidence of ventricular dysfunction after stage 2 construction (PAB, 21%; Norwood, 21%). Conclusions: Bilateral PAB with continuous lipo-prostaglandin E1 administration may improve early and intermediate mortality in infants with HLHS. Intimate care with hospitalisation may contribute to the results.

AB - Objective: To compare the haemodynamics and perioperative course of initial palliation with bilateral pulmonary artery banding (PAB) and the Norwood procedure. Methods: Between April 2004 and December 2007, 43 consecutive children with hypoplastic left heart syndrome (HLHS) or a variant underwent initial palliation (PAB, n = 18; Norwood, n = 25). Clinical perioperative data were analysed. In the PAB group, lipo-prostaglandin E1 administration was continued with hospitalisation until stage 2 palliation with a bi-directional Glenn shunt and the Norwood procedure. Results: There were no significant differences in the age and operative weight of patients who received stage 1 palliation (PAB, 12 ± 9 days, 2.7 ± 0.6 kg; Norwood, 12 ± 8 days, 2.8 ± 0.4 kg). The PAB group had more high-risk patients than the Norwood group (PAB, 83%; Norwood, 48%, p = 0.04). Increased early and inter-stage mortality were observed in patients who underwent the Norwood procedure (early mortality with PAB, 6% vs Norwood, 12%; inter-stage mortality, 6% vs 27%, respectively). Mortality between stages 1 and 2 was 11% for the PAB group and 36% for the Norwood group. The Kaplan-Meier survival estimate at 1 year did not differ between groups (77% for the PAB group, 64% for the Norwood group). Ductal stenosis was found in one patient in the PAB group during the follow-up period. Twenty-eight patients underwent stage 2 reconstruction, and the patients in the PAB group were younger at the time of surgery (PAB, 116 days; Norwood, 224 days). There were no significant differences between groups in pulmonary artery index regarding body surface area (BSA) (PAB, 179 mm2 BSA-1; Norwood, 194 mm2 BSA-1) and the incidence of ventricular dysfunction after stage 2 construction (PAB, 21%; Norwood, 21%). Conclusions: Bilateral PAB with continuous lipo-prostaglandin E1 administration may improve early and intermediate mortality in infants with HLHS. Intimate care with hospitalisation may contribute to the results.

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JO - European Journal of Cardio-thoracic Surgery

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