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Use of routine ventricular assist following the first stage Norwood procedure

Published online by Cambridge University Press:  21 September 2005

Ross M. Ungerleider ,
Irving Shen ,
Grant Burch ,
Robert Butler  and
Michael Silberbach
Ross M. Ungerleider
Affiliation:
Department of Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health and Sciences University, Portland, Oregon, USA
Irving Shen
Affiliation:
Department of Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health and Sciences University, Portland, Oregon, USA
Grant Burch
Affiliation:
Department of Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health and Sciences University, Portland, Oregon, USA
Robert Butler
Affiliation:
Department of Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health and Sciences University, Portland, Oregon, USA
Michael Silberbach
Affiliation:
Department of Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health and Sciences University, Portland, Oregon, USA
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Extract

Surgical treatment of hypoplastic left heart syndrome has generated substantial interest and attention amongst cardiac surgeons since the initial reports from Norwood and his colleagues in 1980.1,2 Initial efforts at most programmes were to create reproducible results, and mortality rates remained high at several institutions throughout the 1980s and 1990s. A recent multi-institutional review demonstrates that the hospital mortality still remains high in numerous centers at the current time.3 Nevertheless, several advances over recent years have led to improved outcomes, and in the best centers, hospital survival now approaches 90%. Survival in successful centers is claimed to relate to the ability of the team to help the patient balance the systemic and pulmonary flows of blood. This ability to balance flow has been enhanced, over recent years, by numerous contributions, including decreasing the size of shunt ordinarily used,4 the use of alpha blockade,5 the rapid deployment of extracorporeal membrane oxygenation,6–8 and various forms of ventilatory manipulation.

Type
Norwood Procedure and Staged Palliation
Information
Cardiology in the Young , Volume 14 , Issue S1 , February 2004 , pp. 61 - 64
Copyright
© 2004 Cambridge University Press

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