en
Scientific article
English

Ring-reinforced Sano right ventricular to pulmonary artery conduit at Norwood stage I

Publication date2016
Abstract

Reinterventions for proximal conduit obstruction or on the pulmonary arteries are frequent after Sano-modified stage I Norwood palliation of hypoplastic left heart syndrome. We report our experience with a modified Sano stage I, in which the right ventricle-to-pulmonary artery (PA) conduit used is reinforced by external rings to avoid collapse, and the conduit is inserted into the right ventricle through a limited ventriculotomy and 'dunked' into the ventricular cavity. In our experience, this modification was associated with fewer reinterventions or complications with the proximal anastomosis (P = 0.046 and 0.004), improved PA pulse pressure (9.1 ± 4.1 vs 4.8 ± 3.8 mmHg in controls, P < 0.001) and Nakata index (213 ± 76 vs 134 ± 68 mm(2)/m(2) in controls, P < 0.0001), although overall survival to a median of 20 months was not significantly different from controls. Right ventricular function at stage II-bidirectional Glen was marginally better in patients with the modified Sano conduit, however not to a significant level. Further evaluation of late ventricular function is currently ongoing.

Keywords
  • Arterial Pressure/physiology
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation/instrumentation/methods
  • Cardiopulmonary Bypass/methods
  • Female
  • Humans
  • Hypoplastic Left Heart Syndrome/surgery
  • Infant
  • Newborn
  • Kaplan-Meier Estimate
  • Male
  • Norwood Procedures/instrumentation/methods
  • Postoperative Complications/prevention & control
  • Pulmonary Artery/physiopathology/surgery
  • Retrospective Studies
Citation (ISO format)
MYERS, Patrick Olivier, EMANI, Sitaram M, BAIRD, Christopher W. Ring-reinforced Sano right ventricular to pulmonary artery conduit at Norwood stage I. In: Multimedia Manual of Cardiothoracic Surgery, 2016, vol. 2016. doi: 10.1093/mmcts/mmv038
Identifiers
ISSN of the journal1813-9175
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