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

Emani, Sitaram M
Baird, Christopher W
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/physiologyBlood Vessel ProsthesisBlood Vessel Prosthesis Implantation/instrumentation/methodsCardiopulmonary Bypass/methodsFemaleHumansHypoplastic Left Heart Syndrome/surgeryInfantNewbornKaplan-Meier EstimateMaleNorwood Procedures/instrumentation/methodsPostoperative Complications/prevention & controlPulmonary Artery/physiopathology/surgeryRetrospective Studies
PMID: 26768103
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Research group L'hypertension pulmonaire (pédiatrie) (228)
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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

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Deposited on : 2017-09-14

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