title: Modification of ventricular-to-pulmonary shunt to minimize proximal conduit obstruction after stage I Norwood reconstruction.
abstract: The use of right ventricle-to-pulmonary artery conduit improved postoperative hemodynamics and survival in hypoplastic left heart syndrome patients. Proximal conduit anastomosis obstruction prompts hypercyanosis and early bidirectional Glenn connection. We describe modification of the proximal right ventricle-to-pulmonary artery conduit anastomosis to eliminate this complication. Outcomes after Norwood operation using standard Sano (group II) versus modified (group I) right ventricle-to-pulmonary artery conduit anastomosis were evaluated. Group II patients had more hospital readmissions for cyanosis (19 vs 1; p < or = 0.05), the Glenn operation at younger age (4.4 vs 5.6 months), and more proximal stenosis (3 [20%] vs zero; p < or = 0.05) than group I. This modification may eliminate progressive proximal stenosis.
authors.affiliation: Department of Cardiothoracic Surgery, Loma Linda University Children's Hospital, Loma Linda, California 92354, USA. nhasaniya@yahoo.com
authors.forename: Nahidh W
authors.initials: NW
authors.lastname: Hasaniya
authors.forename: Howard
authors.initials: H
authors.lastname: Shattuck
authors.forename: Anees
authors.initials: A
authors.lastname: Razzouk
authors.forename: Leonard
authors.initials: L
authors.lastname: Bailey
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007223:Infant; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome