Staged Surgical Approach in Neonates with a Functionally Single Ventricle and Arch Obstruction: Pulmonary Artery Banding and Aortic Arch Reconstruction ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-01

AUTHORS

Noriyoshi Kajihara, Toshihide Asou, Yuko Takeda, Yoshimichi Kosaka, Hiroyuki Nagafuchi, Ryusuke Oyama, Seiyo Yasui

ABSTRACT

The success rate of right-heart bypass surgery in patients with a functionally single ventricle (f-SV) and systemic obstruction is low. In patients with a high risk of subaortic stenosis, we performed an initial step of pulmonary artery banding (PAB) and arch reconstruction before placing a bidirectional cavopulmonary shunt (BCPS) in infants with or without Damus-Kaye-Stansel (DKS) anastomosis. We assessed the success of right-heart bypass surgery. Between October 2003 and August 2008, we performed surgery in 19 neonates (median age 5 days) with f-SV and arch obstruction. Extended aortic arch anastomosis, with or without distal arch augmentation, was performed in 10 patients, and subclavian flap aortoplasty was performed in 9 patients. The circumference of the PAB was determined as the individual patient's body weight in kilograms plus 16.2 +/- 3.7 mm. Eighteen of 19 infants (95%) underwent successful BCPS placement at a median age of 7.8 months. DKS anastomosis was performed concomitantly during BCPS placement in 11 infants in whom subaortic stenosis was morphologically suspected but not demonstrated physiologically. As our first-stage operation, arch reconstruction plus PAB provided high success rates for right-heart bypass operations. This strategy is not leading, but it is a reliable approach for progression along a Fontan pathway. More... »

PAGES

33-39

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00246-009-9540-0

DOI

http://dx.doi.org/10.1007/s00246-009-9540-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1044855790

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19812881


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