Article
Cardiac & Cardiovascular Systems
Isaac Wamala, Kevin G. Friedman, Mossab Y. Saeed, Kimberlee Gauvreau, Laura Gellis, Michele Borisuk, Aditya Kaza, Sitaram Emani, Pedro J. del Nido, Christopher W. Baird
Summary: The study aimed to describe the outcomes of tricuspid valve reconstruction (TVR) concomitant with the Norwood operation in patients with hypoplastic left heart syndrome (HLHS) and evaluate the structural factors associated with successful functional correction. The study found that improvement in tricuspid regurgitation (TR) grade and having mild TR at discharge were associated with improved reintervention and TR-free survival. Patients with successful functional correction had smaller preoperative tricuspid annulus lateral dimensions, tricuspid valve area, and right ventricle midwidth.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Diego Ramonfaur, Xiaoya Zhang, Abraham P. Garza, Jose Fernando Garcia-Pons, Sylvia C. Britton-Robles
Summary: Hypoplastic left heart syndrome is a rare congenital disorder that causes early childhood death if left untreated. The complex treatment process involves multiple surgical procedures at different stages, including the Norwood, bidirectional Glenn, and Fontan procedures. The prognosis has improved in recent decades, but is still influenced by various factors. Novel alternatives have been proposed to improve survival and neurodevelopment, but are not widely used. Attention has also been given to improving the neurodevelopmental outcomes and quality of life for these patients.
CARDIOLOGY IN REVIEW
(2023)
Review
Pediatrics
Walter Knirsch, Alexandra De Silvestro, Michael von Rhein
Summary: Background: Patients with hypoplastic left heart syndrome (HLHS) undergoing staged palliation until Fontan procedure are at risk for impaired neurodevelopmental outcome. The Hybrid procedure with bilateral pulmonary artery banding, ductal stenting, and balloon atrioseptostomy may offer a less invasive stage I procedure compared to the Norwood stage I procedure. This review analyzed neurodevelopmental and functional outcomes after Hybrid procedure as stage I procedure.
FRONTIERS IN PEDIATRICS
(2023)
Article
Cardiac & Cardiovascular Systems
Kendall M. Lawrence, Richard F. Ittenbach, Mallory L. Hunt, Michelle Kaplinski, Chitra Ravishankar, Jack Rychik, James M. Steven, Stephanie M. Fuller, Susan C. Nicolson, J. William Gaynor, Thomas L. Spray, Christopher E. Mascio
Summary: In children with hypoplastic left heart syndrome who survived superior cavopulmonary connection, over three decades, over 8% failed to undergo the Fontan procedure and this rate has remained stable. The use of a right ventricle to pulmonary artery shunt during the Norwood procedure was associated with increased attrition.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Shigemitsu Iwai, Koji Miwa, Toshiaki Nagashima
Summary: The association between hypoplastic left heart syndrome and valvular pulmonary stenosis is very rare, and the severity of valvular pulmonary stenosis in this condition limits treatment options. However, we describe a patient in this article who underwent the Norwood procedure with neoaortic valve reconstruction successfully, suggesting it as a potential option for this challenging condition.
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Ahmed F. Elmahrouk, Mohamed F. Ismail, Amr A. Arafat, Ahmed M. Dohain, Azzahra M. Edrees Mbbs, Ahmed A. Jamjoom Mbbs, Osman O. Al-Radi
Summary: This study demonstrates the feasibility of using a primary cavopulmonary shunt as part of the initial Norwood palliation in patients with unrestricted pulmonary blood flow and low pulmonary vascular resistance. Delayed chest closure and postoperative inhaled nitric oxide were required in some patients, but overall results suggest that the initial use of the cavopulmonary shunt is effective and provides a foundation for further surgical strategies.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Anna K. Michalowski, Kimberlee Gauvreau, Aditya Kaza, Luis Quinonez, David Hoganson, Pedro del Nido, Meena Nathan
Summary: This study validated the Technical Performance Score (TPS) as a predictor of short- and long-term outcomes after the Norwood procedure. The results showed an association between TPS and reintervention risk, hospital length of stay, and transplant-free survival. Patients with no residual lesions had improved long-term prognosis, suggesting TPS may help identify high-risk patients for closer monitoring and potential early intervention.
ANNALS OF THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Masamichi Ono, Takashi Kido, Marie Wallner, Melchior Burri, Julia Lemmer, Peter Ewert, Martina Strbad, Julie Cleuziou, Alfred Hager, Jurgen Hoerer
Summary: This study evaluated the outcomes of neonates undergoing the Norwood procedure with modified Blalock-Taussig shunt (MBTS) or right ventricular-pulmonary artery conduit (RVPAC). The results showed no significant difference in early mortality, inter-stage attritions, or overall survival between the two types of shunts during a maximum follow-up period of 18.8 years.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Pediatrics
Rodrigo Freire Bezerra, Juliana Torres Pacheco, Victor Hugo Volpatto, Sonia Meiken Franchi, Rosangela Fitaroni, Denilson Vieira da Cruz, Rodrigo Moreira Castro, Luciana da Fonseca da Silva, Jose Pedro da Silva
Summary: This study reviewed the use of ECMO support in HLHS patients after the Norwood procedure and found that longer ECMO support time and low urine output were associated with higher mortality risk.
FRONTIERS IN PEDIATRICS
(2022)
Article
Cardiac & Cardiovascular Systems
Carsten Rickers, Philip Wegner, Michael Silberbach, Erin Madriago, Dominik Daniel Gabbert, Arash Kheradvar, Inga Voges, Jens Scheewe, Tim Attmann, Michael Jerosch-Herold, Hans-Heiner Kramer
Summary: The coronary microcirculation of the systemic ventricle in young HLHS patients shows significant differences compared with controls. Independent risk factors for reduced hyperemic MBF included HLHS subtype, late gadolinium enhancement, right ventricular diastolic dysfunction, and increasing age at total cavopulmonary connection. The coronary conductance was negatively correlated with systemic blood oxygen saturation.
CIRCULATION-CARDIOVASCULAR IMAGING
(2021)
Editorial Material
Medicine, General & Internal
Pasquale Giugliano, Paola Ciamarra, Mariavictoria De Simone, Alessandro Feola, Pierluca Zangani, Carlo Pietro Campobasso, Gelsomina Mansueto
Summary: The article presents a case of HLHS in a newborn that was not diagnosed prenatally. Autopsy results revealed hypoplasia of the left and right cardiac cavities. The study emphasizes the importance of early diagnosis for successful surgical intervention.
Article
Cardiac & Cardiovascular Systems
Taufiek Konrad Rajab, Max B. Mitchell
Summary: NART is an underappreciated complication of Norwood palliation with high mortality. There should be a high index of suspicion for NART in patients after Norwood palliation with an unexplained complicated clinical course. Importantly, NART is frequently missed by TTE.
ANNALS OF THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Emily R. Backes, Natasha S. Afonso, Danielle Guffey, James S. Tweddell, Sarah Tabbutt, Nancy A. Rudd, Ginny O'Harrow, Silvana Molossi, George M. Hoffman, Garick Hill, Jeffrey S. Heinle, Priya Bhat, Jeffrey B. Anderson, Nancy S. Ghanayem
Summary: Prematurity, low birth weight, genetic syndromes, extracardiac conditions, and secondary cardiac lesions are considered high-risk conditions associated with mortality after stage 1 palliation. The presence of a single high-risk diagnosis is not associated with decreased survival at 1 year, but cumulative diagnoses across multiple high-risk diagnostic categories are associated with decreased odds of survival. Further patient accrual is needed to evaluate the impact of specific comorbid conditions within the broader high-risk categories.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Robert A. Cesnjevar, Frank Harig, Moritz Dietz, Muhannad Alkassar, Wolfgang Waellisch, Andre Rueffer, Sven Dittrich, Ariawan Purbojo
Summary: Surgical creation of an innominate vein is an effective method to relieve LSVC-related obstructions and promote mitral valvar growth in patients with complex cardiac anomalies. The study of 19 patients showed good surgical outcomes with high survival rates, indicating the potential of this procedure for LSVC-related issues in the future.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Review
Cardiac & Cardiovascular Systems
Hannah Bellsham-Revell
Summary: Hypoplastic left heart syndrome is a spectrum of left heart underdevelopment that requires staged palliation to the Fontan circulation for management, with potential long-term intervention needed for the branch pulmonary arteries. Echocardiography is the mainstay for assessment, but MRI and CT are increasingly used for more challenging extracardiac structures. Both MRI and CT require specific conditions and training, but can provide excellent imaging guidance for interventions.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)