title: Modified Norwood procedure with a handmade down-sizing valved right ventricle-to-pulmonary artery conduit.
abstract: First-stage palliation of hypoplastic left heart syndrome has been revolutionized by the recent introduction of a right ventricle-to-pulmonary artery (RV-PA) conduit as an alternative to a systemic-to-pulmonary shunt. However, most conduits are unvalved, and the use of valved xenografts was abandoned during the early era of this operation. We performed a successful modified Norwood operation in a 2-month-old infant with aortic atresia and ventricular and atrial septal defects using a hand-made down-sizing valved graft as an RV-PA conduit. The postoperative course was uneventful with well-balanced pulmonary and arterial perfusion. We believe that minimization of the regurgitant volume from an unvalved prosthetic conduit by utilizing this modification might be of benefit in this particular group of patients.
authors.affiliation: Department of Cardiac Surgery, The Jikei University, Nishi Shimbashi, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Yamashiro
authors.forename: Kiyozo
authors.initials: K
authors.lastname: Morita
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Uno
authors.forename: Gen
authors.initials: G
authors.lastname: Shinohara
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hashimoto
mesh_terms: D001807:Blood Vessel Prosthesis; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D008297:Male; D058327:Norwood Procedures / Q000295:instrumentation*; D010166:Palliative Care; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome