The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 3 , Pages 528-537 , September 2009

The Norwood procedure using a right ventricle–pulmonary artery conduit: Comparison of the right-sided versus left-sided conduit position

  • David J. Barron, FRCS

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
    • Corresponding Author InformationAddress for reprints: David J. Barron, FRCS, Consultant Cardiac Surgeon, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom.
  • ,
  • Andre Brooks, MD

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • John Stickley, BSc

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • Steven M. Woolley, FRCS

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • Oliver Stümper, PhD

      Affiliations

    • Department of Pediatric Cardiology, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • Timothy J. Jones, FRCS

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • William J. Brawn, FRCS

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom

Received 23 September 2008 ,Revised 2 March 2009 ,Accepted 13 May 2009.

References 

  1. Norwood WI, Lang P, Hansen DD. Physiologic repair of aortic atresia-hypoplastic left heart syndrome. N Engl J Med. 1983;308:23–26
  2. Pizarro C, Malec E, Maher KO, Januszewska K, Gidding SS, Murdison KA, et al. Right ventricle to PA conduit improves outcome after stage I Norwood for hypoplastic left heart syndrome. Circulation. 2003;108:II155–II160
  3. Tweddell JS, Hoffman GM, Mussatto KA, Fedderly RT, Berger S, Jaquiss RD, et al. Improved survival of patients undergoing palliation of hypoplastic left heart syndrome: lessons learned from 115 consecutive patients. Circulation. 2002;106:I82–I89
  4. Sano S, Ishino K, Kawada M, Honjo O. Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2004;7:22–31
  5. Azakie T, Merklinger SL, McCrindle BW, Van Arsdell GS, Lee KJ, Benson LN, et al. Evolving strategies and improving outcomes of the modified Norwood procedure: a 10-year single-institution experience. Ann Thorac Surg. 2001;72:1349–1353
  6. Norwood WI, Lang P, Casteneda AR, Campbell DN. Experience with operations for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 1981;82:511–519
  7. Sano S, Ishino K, Kawada M, Arai S, Kasahara S, Asai T, et al. Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2003;126:504–509
  8. Maher KO, Pizarro C, Gidding SS, Januszewska K, Malec E, Norwood WI, et al. Hemodynamic profile after the Norwood procedure with right ventricle to pulmonary artery conduit. Circulation. 2003;108:782–784
  9. Malec E, Januszewska K, Kolcz J, Mroczek T. Right ventricle-to-pulmonary artery shunt versus modified Blalock-Taussig shunt in the Norwood procedure for hypoplastic left heart syndrome—influence on early and late haemodynamic status. Eur J Cardiothorac Surg. 2003;23:728–733
  10. Rumball EM, McGuirk SP, Stumper O, Laker SJ, de Giovanni JV, Wright JG, et al. The RV-PA conduit stimulates better growth of the pulmonary arteries in hypoplastic left heart syndrome. Eur J Cardiothorac Surg. 2005;27:801–806
  11. Graham EM, Atz AM, Bradley SM, Scheurer MA, Bandisode VM, Laudito A, et al. Does a ventriculotomy have deleterious effects following palliation in the Norwood procedure using a shunt placed from the right ventricle to the pulmonary arteries?. Cardiol Young. 2007;17:145–150
  12. Li J, Zhang G, McCrindle BW, Holtby H, Humpl T, Cai S, et al. Profiles of hemodynamics and oxygen transport derived by using continuous measured oxygen consumption after the Norwood procedure. J Thorac Cardiovasc Surg. 2007;133:441–448
  13. McGuirk SP, Stickley J, Griselli M, Stumper OF, Laker SJ, Barron DJ, et al. Risk assessment and early outcome following the Norwood procedure for hypoplastic left heart syndrome. Eur J Cardiothorac Surg. 2006;29:675–681
  14. Tatum GH, Sigfússon G, Ettedgui JA, Myers JL, Cyran SE, Weber HS, et al. Pulmonary artery growth fails to match the increase in body surface area after the Fontan operation. Heart. 2006;92:511–514
  15. Edwards L, Morris KP, Siddiqui A, Harrington D, Barron D, Brawn W. Norwood procedure for hypoplastic left heart syndrome: BT shunt or RV-PA conduit?. Arch Dis Child Fetal Neonatal Ed. 2007;92:F210–F214
  16. Reinhartz O, Reddy VM, Petrossian E, MacDonald M, Lamberti JJ, Roth SJ, et al. Homograft valved right ventricle to pulmonary artery conduit as a modification of the Norwood procedure. Circulation. 2006;114(suppl):I594–I599
  17. Pigula FA. Arch reconstruction without circulatory arrest: scientific basis for continued use and application to patients with arch anomalies. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2002;5:104–115
  18. Kitaichi T, Chikugo F, Kawahito T, Hori T, Masuda Y, Kitagawa T. Suitable shunt size for regulation of pulmonary blood flow in a canine model of univentricular parallel circulations. J Thorac Cardiovasc Surg. 2003;125:71–78
  19. Ballweg JA, Dominguez TE, Ravishanker C, Kreutzer J, Marino BS, Bird GL, et al. A contemporary comparison of the effect of shunt type in hypoplastic left heart syndrome on the haemodynamics and outcome at stage 2 reconstruction. J Thorac Cardiovasc Surg. 2007;134:297–303
  20. Aortic atresia and hypoplastic left heart syndrome. In:  Litwin SB editors. Color atlas of congenital heart surgery. 2nd ed. New York: Springer Publishing; 2007;p. 402–414
  21. Pearl JM, Nelson DP, Schwartz SM, Manning PB. First-stage palliation for hypoplastic left heart syndrome in the twenty-first century. Ann Thorac Surg. 2002;73:331–339
  22. Gaynor JW, Mahle WT, Cohen MI, Ittenbach RF, DeCampli WM, Steven JM, et al. Risk factors for mortality after the Norwood procedure. Eur J Cardiothorac Surg. 2002;22:82–89
  23. Mahle WT, Spray TL, Gaynor JW, Clark BJ. Unexpected death after reconstructive surgery for hypoplastic left heart syndrome. Ann Thorac Surg. 2001;71:61–65
  24. Ghanayem NS, Hoffman GM, Mussatto KA, Cava JR, Frommelt PC, Rudd NA, et al. Home surveillance program prevents interstage mortality after the Norwood procedure. J Thorac Cardiovasc Surg. 2003;126:1367–1377
  25. McGuirk SP, Griselli M, Stumper OF, Rumball EM, Miller P, Dhillon R, et al. Staged surgical management of hypoplastic left heart syndrome: a single institution 12 year experience. Heart. 2006;92:364–370

 Read at the Eighty-eighth Annual Meeting of The American Association for Thoracic Surgery, San Diego, Calif, May 10–14, 2008.

PII: S0022-5223(09)00693-X

doi: 10.1016/j.jtcvs.2009.05.004

The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 3 , Pages 528-537 , September 2009