THE “DOUBLE DUNK” TECHNIQUE FOR A RIGHT VENTRICLE TO PULMONARY ARTERY CONDUIT FOR THE NORWOOD PROCEDURE REDUCES THE UNINTENDED SHUNT-RELATED EVENTS.
Journal Title: INTERNATIONAL JOURNAL OF PURE MEDICAL RESEARCH - Year 2019, Vol 4, Issue 2
Abstract
Background: We describe how several modications employed in the RVPAc for the NP may inuence the interstage course, surgical or catheter-based unintended interventions and pulmonary arteries development in the HLHS cohort of patients. Methods: We performed a retrospective analysis of three groups of non-selected, consecutive neonates who underwent the NP between 2011 and 2014, with different RVPAc surgical techniques employed: Group I - the left RVPAc with distal homograft cuff [N=32], Group II – the right RVPAc with distal homograft cuff [N=28], Group III – the “double dunk” right reinforced RVPAc [N=41]. Results: There was no intergroup difference in terms of age, weight, prevalence of aortic atresia, diameter of the ascending aorta, deep hypothermic circulatory arrest time and hospital mortality rate (9.3 vs. 14.2 vs. 7.3%, respectively) between the groups. There was a signicant reduction in the numbers of catheter-based interventions during the interstage period in the third group (34 vs. 25 vs. 0%, respectively, p<0.05) and/or concomitant surgical interventions (17.2 vs. 4.1 vs. 2.6%, respectively). The diameter of the pulmonary arteries was the most homogenous in the third group. Conclusion: The modied strategy of using the “double dunk”, right reinforced RVPAc during the Norwood procedures for HLHS signicantly reduces the number of catheter-based and surgical unintended shunt-related reinterventions during the interstage period. This strategy allows for a more homogenous development of pulmonary arteries before the second surgical stage.
Authors and Affiliations
Tomasz Mroczek, Julita Sacharczuk, Rafał Żurek, Aleksandra Morka, Jerzy Jarosz, Maciej Sniechowski, Janusz H. Skalski
Keywords
Related Articles
- EP ID EP598830
- DOI -
- Views 105
- Downloads 0
RELIGION IMPACT ON ACUTE SCHIZOPHRENIA IN IRAQ
Background: Religion plays an important role in symptoms phenomenology, attribution and management in the Arab culture. Mentally ill patients in the Arab countries tend to pass through different health care providing lt...
EFFECT OF MDR1 GENE POLYMORPHISMS ON RESPONSE TO ORAL PREDNISOLONE IN EGYPTIAN IMMUNE THROMBOCYTOPENIC PATIENTS
Immune thrombytopenia(ITP) is an autoimmune disorder characterized by heterogeneous bleeding manifestations as well as marked-inter individual variation in response to glucocorticoid (GCs); the 1st line ITP treatment. Th...
RELATIONSHIP BETWEEN PROCALCITONIN LEVEL AND BACTERIAL TYPE IN UROSEPSIS PATIENTS AT THE H. ADAM MALIK CENTRAL GENERAL HOSPITAL IN MEDAN
Urosepsis is dened as sepsis (septicemia syndrome) which is caused by an infection of the urinary tract. In sepsis, increased levels of procalcitonin in the blood have a signicant value that can be used as biomarkers o...
POSTOBSTRUCTIVE NEGATIVE PRESSURE PULMONARY EDEMA
Acute pulmonary negative pressure edema (NPPE) also known as post-obstructive pulmonary edema is a life-threatening clinical scenario in which pulmonary edema develops immediately after upper airway obstruction. A review...
ROLE OF PLATELET RICH PLASMA IN TREATMENT OF ROTATOR CUFF TENDINOPATHY AND PARTIAL THICKNESS TEAR: FOLLOW UP BY ULTRASOUND
The pathophysiology of RCT is characterized by progressive, degenerative changes within the tendon as a result of overuse, altered shoulder mechanics, and a limitation of the normal tendon repair system with a broblasti...