The Modified Norwood Procedure at Necker Hospital: Stage I and II for Hypoplastic Left Heart Syndrome

Q3 Medicine Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2022-09-01 DOI:10.1053/j.optechstcvs.2022.04.009

Margaux Pontailler, Régis Gaudin, Olivier Raisky

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引用次数: 1

Abstract

We describe a modified Stage I neonatal surgical palliation for hypoplastic left heart syndrome inspired by both the Norwood and hybrid procedures. This new technique consists in: (1) replacement of the patent ductus arteriosus and aortic arch plasty with a pulmonary homograft, (2) banding of both the right and left pulmonary arteries (PA), (3) atrial septectomy, and (4) reimplantation of the Aorta (when needed). This surgery is performed under cardio-pulmonary bypass without aortic cross clamping, except when the ascending Aorta is atretic and needs to be reimplanted. Stage II consists in the division of the pulmonary bifurcation, PA branch plasty (with debanding), bidirectional cavopulmonary shunt and Damus-Kaye-Stansel anastomosis. This new surgical procedure allowed us to obtain hemodynamically stable postoperative patients and decrease by twice our mortality rate after Stage I palliation in hypoplastic left heart syndrome but with frequent left PA stenosis or hypoplasia.

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内克尔医院改良的诺伍德手术:左心发育不全综合征的一期和二期

我们描述了一种改良的I期新生儿手术姑息治疗左心发育不全综合征的灵感来自诺伍德和混合程序。这项新技术包括:(1)用肺同种移植物替代动脉导管未闭和主动脉弓成形术，(2)左右肺动脉(PA)系带，(3)房间隔切除术，(4)主动脉再植(必要时)。除升主动脉闭锁需要重新植入术外，该手术在心肺旁路下进行，无需主动脉交叉夹紧。II期包括肺分叉的分割，PA分支成形术(带剥离)，双向腔隙肺分流术和Damus-Kaye-Stansel吻合。这种新的外科手术方法使我们获得了血流动力学稳定的术后患者，并使左心发育不全综合征但经常出现左左贲门狭窄或发育不全的I期缓解后的死亡率降低了两倍。

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Operative Techniques in Thoracic and Cardiovascular Surgery Medicine-Surgery

CiteScore

1.40

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0.00%

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期刊介绍： Operative Techniques in Thoracic and Cardiovascular Surgery provides richly illustrated articles on techniques in thoracic and cardiovascular surgery written by renowned surgeons. Each issue presents cardiothoracic topics in adult cardiac, congenital, and general thoracic surgery. Each specialty of interest to the thoracic and cardiovascular surgeon is explored through two different approaches to a specific surgical challenge. Each article is thoroughly illustrated with original line drawings, actual intraoperative photos, and supporting tables and graphs.

期刊最新文献

Editorial Board Table of Contents Modified Aortic Arch Reconstruction Combined With Pulmonary Artery Reconstruction in the Comprehensive Stage II Operation Following a Hybrid Stage I for Hypoplastic Left Heart Syndrome Modified Aortic Valve Neocuspidization (Ozaki AVNeo) Procedure Senning Procedure: Use of a 3D Printed, Silicone Molded Model for Surgical Training