The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 3 , Pages 537-544 , September 2010

A contemporary comparison of the effect of shunt type in hypoplastic left heart syndrome on the hemodynamics and outcome at Fontan completion

Read at the Eighty-ninth Annual Meeting of the American Association for Thoracic Surgery, May 11, 2009, Boston, Massachusetts.

  • Jean A. Ballweg, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • Corresponding Author InformationAddress for reprints: Jean A Ballweg, MD, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Heart Institute, 50 N Dunlap St, Memphis, TN 38103.
    • ,
  • Troy E. Dominguez, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • Chitra Ravishankar, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • J. William Gaynor, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • Susan C. Nicolson, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • Thomas L. Spray, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • Sarah Tabbutt, MD, PhD

      Affiliations

    • University of California San Francisco, San Francisco, Calif

Received 10 May 2009 ,Revised 11 January 2010 ,Accepted 21 March 2010.

References 

  1. Tabbutt S, Dominguez TE, Ravishankar C, Marino BS, Gruber PJ, Wernovsky G, et al. Outcomes after the stage I reconstruction comparing the right ventricular to pulmonary artery conduit with the modified Blalock Taussig shunt. Ann Thorac Surg. 2005;80:1582–1591
  2. Ballweg JA, Dominguez TE, Ravishankar 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 hemodynamics and outcome at stage 2 reconstruction. J Thorac Cardiovasc Surg. 2007;134:297–303
  3. Lai L, Laussen PC, Cua CL, Wessel DL, Costello JM, del Nido PJ, et al. Outcomes after bidirectional Glenn operation: Blalock-Taussig shunt versus right ventricle-to-pulmonary artery conduit. Ann Thorac Surg. 2007;83:1768–1773
  4. Januszewska K, Stebel A, Malec E. Consequences of right ventricle-to-pulmonary artery shunt at the first stage for the Fontan operation. Ann Thorac Surg. 2007;84:1611–1617
  5. Scheurer MA, Salvin JW, Vida VL, Fynn-Thompson F, Bacha EA, Pigula FA, et al. Survival and clinical course at Fontan after stage one palliation with either a modified Blalock-Taussig shunt or a right ventricle to pulmonary artery conduit. J Am Coll Cardiol. 2008;52:52–59
  6. Bove EL, Lloyd TR. Staged reconstruction for hypoplastic left heart syndrome. Contemporary results. Ann Surg. 1996;224:387–395
  7. Bove EL. Current status of staged reconstruction for hypoplastic left heart syndrome. Pediatr Cardiol. 1998;19:308–315
  8. Mahle WT, Spray TL, Wernovsky G, Gaynor JW, Clark BJ. Survival after reconstructive surgery for hypoplastic left heart syndrome: a 15 year experience from a single institution. Circulation. 2000;102(suppl 3):III36–III41
  9. Malec E, Januszewska K, Kolz J, Pajak J. Factors influencing early outcome of Norwood procedure for hypoplastic left heart syndrome. Eur J Cardiothorac Surg. 2000;18:202–206
  10. Azakie A, Sl Merklinger, 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
  11. 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(suppl I):I82–I89
  12. Norwood WI, Lang P, Castaneda AR, Campbell DN. Experience with operations for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 1981;82:511–519
  13. 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;126:504–510
  14. Sano S, Ishino K, Kado H, Shiokawa Y, Sakamoto K, Yokota M, et al. Outcome of right ventricle to pulmonary artery shunt in first stage palliation of hypoplastic left heart syndrome: a multi-institutional study. Ann Thorac Surg. 2004;78:1951–1958
  15. Sano S, Ishino K, Kawada M, Yoshizumi K, Takeuchi M, Ohtsuki S. Experience over five years using a shunt placed between the right ventricle and the pulmonary arteries during initial reconstruction of hypoplasia of the left heart. Cardiol Young. 2004;14(Suppl 3):90–95
  16. Mitchell ME, Ittenbach RF, Gaynor JW, Wernovsky G, Nicolson SC, Spray TL. Intermediate outcomes after the Fontan procedure in the current era. J Thorac Cardiovasc Surg. 2006;131:172–180
  17. Hirsch JC, Goldberg C, Bove EL, Salehian S, Lee T, Ohye RG, et al. Fontan operation in the current era. Ann Surg. 2008;248:402–410
  18. Ohye RG, Gaynor JW, Ghanayem NS, Goldberg CS, Laussen PC, Frommelt PC, et al. Design and rationale of a randomized trial comparing the Blalock-Taussig and right ventricle-pulmonary artery shunts in the Norwood procedure. J Thorac Cardiovasc Surg. 2008;136:968–975

 Disclosures: None.

PII: S0022-5223(10)00565-9

doi: 10.1016/j.jtcvs.2010.03.045

The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 3 , Pages 537-544 , September 2010

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