초록접수 현황
| 15F-140 | 구연 발표 |
Mid-term Results of Neonatal Norwood Procedure for the Patients other than Classic HLHS
Jeong-Jun Park¹, Won Kyoun Park¹, Ji Hyun Bang¹, Chun Soo Park¹, Tae-Jin Yun¹, Jae Suk Baek², Jeong Jin Yu², Young-Hwue Kim², Jae-Kon Ko², Hyun Woo Goo³
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea¹, Department of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea², Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea³
Background : The Norwood procedure, the first surgical step of staged palliation for Hypoplastic left heart syndrome, is also applied for other complex single-ventricle lesions with systemic outflow tract or aortic arch obstruction. We reviewed our mid-term results of Norwood procedure for the patients other than classic HLHS, retrospectively since 2011.
Methods : Eight patients underwent Norwood operation in the neonatal period. Mean age and weight at operation was 25days and 3.2kg. Temporary bilateral pulmonary artery banding was done in three patients. Aortic arch was reconstructed with patch material (n=7) under selective cerebral perfusion (mean 46.4min). Ringed RV-PA conduit as a source of pulmonary blood flow was established by dunk technique (5mm in 6 and 6mm in 2). Delayed sternal closure was routine in all patients.
Results : There was one early death and no late mortality. Two patients underwent biventricular repair (completion of Norwood- Rastelli operation; 3.3 and 10.5 months after Norwood procedure) and 4 patients were placed in single ventricle tract (completion Fontan in 2, bidirectional cavo-pulmonary shunt in 2 awaiting Fontan operation). Next surgical strategy is not decided in 1 patient. Two patients needed wound revision. All survived patients are under good clinical condition during a mean follow-up of 31.5 months.
Conclusion : Norwood procedure for properly selected patients provides a good midterm result and is a valid surgical therapy in these patients, with better results than for those with classic HLHS.
Methods : Eight patients underwent Norwood operation in the neonatal period. Mean age and weight at operation was 25days and 3.2kg. Temporary bilateral pulmonary artery banding was done in three patients. Aortic arch was reconstructed with patch material (n=7) under selective cerebral perfusion (mean 46.4min). Ringed RV-PA conduit as a source of pulmonary blood flow was established by dunk technique (5mm in 6 and 6mm in 2). Delayed sternal closure was routine in all patients.
Results : There was one early death and no late mortality. Two patients underwent biventricular repair (completion of Norwood- Rastelli operation; 3.3 and 10.5 months after Norwood procedure) and 4 patients were placed in single ventricle tract (completion Fontan in 2, bidirectional cavo-pulmonary shunt in 2 awaiting Fontan operation). Next surgical strategy is not decided in 1 patient. Two patients needed wound revision. All survived patients are under good clinical condition during a mean follow-up of 31.5 months.
Conclusion : Norwood procedure for properly selected patients provides a good midterm result and is a valid surgical therapy in these patients, with better results than for those with classic HLHS.
책임저자: Jeong-Jun Park
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
연락처 : Jeong-Jun Park, Tel: 02-3010-3587 , E-mail : pkjj@amc.seoul.kr
