Patient-Specific Multi-Scale Model Analysis of Hemodynamics Following the Hybrid Norwood Procedure for Hypoplastic Left Heart Syndrome: Effects of Reverse Blalock–Taussig Shunt Diameter

2018 ◽  
Vol 10 (1) ◽  
pp. 136-154 ◽  
Author(s):  
Andres Ceballos ◽  
Ray Prather ◽  
Eduardo Divo ◽  
Alain J. Kassab ◽  
William M. DeCampli
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Model Analysis ◽  
Norwood Procedure ◽  
Scale Model ◽  
Patient Specific ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Multi Scale ◽  
Left Heart Syndrome ◽  
Blalock Taussig Shunt

scholarly journals Early outcomes and computational fluid dynamic analyses of chimney reconstruction in the Norwood procedure

2019 ◽  
Vol 29 (2) ◽  
pp. 252-259 ◽  
Author(s):  
Satoshi Asada ◽  
Masaaki Yamagishi ◽  
Keiichi Itatani ◽  
Yoshinobu Maeda ◽  
Satoshi Taniguchi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Hypoplastic Left Heart Syndrome ◽  
Fluid Dynamic ◽  
Norwood Procedure ◽  
Patient Specific ◽  
Shear Stresses ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Flow Profiles ◽  
Left Heart Syndrome

Abstract OBJECTIVES The ideal configuration of a reconstructed aortic arch in the Norwood procedure for hypoplastic left heart syndrome is still a matter of debate. Chimney reconstruction was developed to avoid postoperative complications and turbulent flow in the aortic arch. This study sought to clarify early outcomes of the procedure and verify its haemodynamic advantages using computational fluid dynamics (CFD). METHODS Fourteen consecutive patients with hypoplastic left heart syndrome or a variant who underwent chimney reconstruction in the Norwood procedure between January 2013 and March 2018 were enrolled. Median age and body weight at the time of operation were 2.5 months and 4.1 kg, respectively. Thirteen patients (93.9%) had been palliated with previous bilateral pulmonary artery (PA) banding. In addition, patient-specific CFD models of neoarches based on postoperative computed tomograms from 6 patients were created and the flow profiles analysed. RESULTS Survival rates at 1, 3 and 5 years were 76.6%, 67.3% and 67.3%, respectively. No patient developed left PA compression by neoaorta, neoaortic dilation or neoaortic insufficiency. Only 2 patients (14.3%) required surgical intervention for recoarctation. Fontan completion was performed on 5 patients. On CFD analysis, all reconstructed aortic arches showed low energy loss (9.16–14.4 mW/m2) and low wall shear stresses. CONCLUSIONS Chimney reconstruction was a feasible technique when homografts were not readily available. CFD analyses underscored the fact that this technique produced excellent flow profiles. Larger studies should be conducted to clarify long-term outcomes.

Early Developmental Outcome After the Norwood Procedure for Hypoplastic Left Heart Syndrome

PEDIATRICS ◽  
1998 ◽  
Vol 102 (5) ◽  
pp. 1148-1152 ◽  
Author(s):  
Jeffrey H. Kern ◽  
Veronica J. Hinton ◽  
Nancy E. Nereo ◽  
Constance J. Hayes ◽  
Welton M. Gersony
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Norwood Procedure ◽  
Developmental Outcome ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Left Heart Syndrome ◽  
Early Developmental

Hypoplastic Left Heart Syndrome: Natural History in a Geographically Defined Population

PEDIATRICS ◽  
1990 ◽  
Vol 85 (6) ◽  
pp. 977-983
Author(s):  
Cynthia D. Morris ◽  
Jacquelyn Outcalt ◽  
Victor D. Menashe
Keyword(s):  
Natural History ◽  
Hypoplastic Left Heart Syndrome ◽  
Congenital Heart ◽  
Heart Defects ◽  
Norwood Procedure ◽  
Secular Change ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
History Of ◽  
Left Heart Syndrome

Advances in surgical treatment of hypoplastic left heart syndrome with the Norwood procedure and cardiac transplantation have made essential the understanding of the natural history of hypoplastic left heart syndrome. In a geographically defined population, we ascertained the prevalence of hypoplastic left heart syndrome in children born in Oregon from 1971 through 1986. Clinical and anatomic data were extracted from the charts of the 98 affected children and the survival rate was calculated. Hypoplastic left heart syndrome occurred in 0.162 per 1000 live births in Oregon during this period. No syndrome complex was prevalent and 84% were free of other congenital malformations. However, there was an increased occurrence of congenital heart defects in first-degree relatives of probands with hypoplastic left heart syndrome. Of the affected children 15 ± 4% died on the first day of life, 70 ± 5% died within the first week, and 91 ± 3% died within 30 days. No secular change in survival occurred during the study. Palliation with the Norwood procedure was performed in 20 children. Although survival was significantly improved with this surgery (P = .01), the effect was observed principally through 30 days of life and only one of these children remains alive. Hypoplastic left heart syndrome is a lethal congenital heart defect in children and poses management and ethical dilemmas.

GASTROINTESTINAL MORBIDITY IN PATIENTS WITH HYPOPLASTIC LEFT HEART SYNDROME FOLLOWING THE NORWOOD PROCEDURE

2002 ◽  
Vol 30 (Supplement) ◽  
pp. A73 ◽  
Author(s):  
Howard E Jeffries ◽  
Randall C Wetzel ◽  
Vaughn A Starnes ◽  
Mary McCulley ◽  
David Y Moromisato
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Norwood Procedure ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Left Heart Syndrome
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