Ring-reinforced Sano right ventricular to pulmonary artery conduit at Norwood stage I.
|Published in||Multimedia Manual of Cardiothoracic Surgery. 2016, vol. 2016|
|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|
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|Research group||L'hypertension pulmonaire (pédiatrie) (228)|
|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 https://archive-ouverte.unige.ch/unige:96722|