scholarly journals Evaluation of bilateral pulmonary artery banding for initial palliation in single-ventricle neonates and infants: risk factors for mortality before the bidirectional Glenn procedure

2014 ◽  
Vol 19 (5) ◽  
pp. 807-811 ◽  
Author(s):  
Yoichiro Ishii ◽  
Noboru Inamura ◽  
Futoshi Kayatani ◽  
Shigemitsu Iwai ◽  
Hiroaki Kawata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Artery ◽  
Single Ventricle ◽  
Pulmonary Artery Banding ◽  
Bidirectional Glenn ◽  
Bilateral Pulmonary Artery Banding ◽  
Neonates And Infants ◽  
Bidirectional Glenn Procedure ◽  
Glenn Procedure

Effect of Accessory Pulmonary Blood Flow on Survival After the Bidirectional Glenn Procedure

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Richard D. Mainwaring ◽  
John J. Lamberti ◽  
Karen Uzark ◽  
Robert L. Spicer ◽  
Mark W. Cocalis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Mortality Rate ◽  
Pulmonary Blood Flow ◽  
Single Ventricle ◽  
Fontan Operation ◽  
Right Ventricular Outflow Tract ◽  
Bidirectional Glenn ◽  
Actuarial Analysis ◽  
Bidirectional Glenn Procedure ◽  
Glenn Procedure

Background —The bidirectional Glenn procedure (BDG) is used in the staged surgical management of patients with a functional single ventricle. Controversy exists regarding whether accessory pulmonary blood flow (APBF) should be left at the time of BDG to augment systemic saturation or be eliminated to reduce volume load of the ventricle. The present study was a retrospective review of patients undergoing BDG that was conducted to assess the influence of APBF on survival rates. Methods and Results —From 1986 through 1998, 149 patients have undergone BDG at our institution. Ninety-three patients had elimination of all sources of APBF, whereas 56 patients had either a shunt or a patent right ventricular outflow tract intentionally left in place to augment the pulmonary blood flow provided by the BDG. The operative mortality rate was 2.2% without APBF and 5.4% with APBF. The late mortality rate was 4.4% without APBF and 15.1% with APBF. Actuarial analysis demonstrates a divergence of the Kaplan-Meier curves in favor of patients in whom APBF was eliminated ( P <0.02). One hundred seven patients have subsequently undergone completion of their Fontan operation, so the actuarial analysis includes the operative risk of this second operation. Conclusions —The results suggest that the elimination of APBF at the time of BDG may confer a long-term advantage for patients with a functional single ventricle.

scholarly journals The Nutritional Status of Pediatric Patients with Single Ventricle Undergoing a Bidirectional Glenn Procedure

2020 ◽  
Vol 41 (8) ◽  
pp. 1594-1600
Author(s):  
Wen-Yi Luo ◽  
Zhuo-Ming Xu ◽  
Yue-Yue Zhang ◽  
Li Hong ◽  
Ming-Jie Zhang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pediatric Patients ◽  
Single Ventricle ◽  
Bidirectional Glenn ◽  
Bidirectional Glenn Procedure ◽  
Glenn Procedure

Bilateral Pulmonary Artery Banding before Norwood Procedure: Survival of High-Risk Patients

2019 ◽  
Vol 68 (01) ◽  
pp. 030-037 ◽  
Author(s):  
Antonia Schulz ◽  
Nicodème Sinzobahamvya ◽  
Mi-Young Cho ◽  
Wolfgang Böttcher ◽  
Oliver Miera ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Pulmonary Artery ◽  
Lower Risk ◽  
Pulmonary Artery Banding ◽  
Norwood Procedure ◽  
High Risk Patients ◽  
Significant Difference ◽  
Bilateral Pulmonary Artery Banding ◽  
Risk Patients

Background This study reports midterm results of high-risk patients with hypoplastic left ventricle treated with initial bilateral pulmonary artery banding (PAB) before secondary Norwood procedure (NP). Methods Retrospective study of 17 patients admitted between July 2012 and February 2017 who underwent this treatment strategy because diagnosis or clinical status was associated with high risk for NP. Survival was compared with that of patients who underwent primary NP. Results Mean Aristotle comprehensive complexity score for NP would have been 19.7 ± 2.6. Risk factors included obstructed pulmonary venous return (n = 9), body weight < 2.5 kg (n = 7), total anomalous pulmonary venous connection (n = 3), and necrotizing enterocolitis (n = 1). Ten patients had a score ≥ 19.5. Early survival after PAB was 82.4% (14/17). NP was performed in 14 patients after improvement of clinical condition at a median age of 56 days and a weight ≥2,500 g. There was no 30-day mortality, but one interstage death. One patient died later after Glenn operation. One-year survival after primary PAB followed by NP was 70.6 ± 11.1%. During the same period, 35 patients with overall lower risk factors underwent primary NP; early postoperative survival and 1-year survival were 88.6 ± 5.4% and 68.6 ± 7.8%, respectively. There was no significant difference in survival between the two groups (p = 0.83) despite higher risk in the secondary Norwood group (p <0.0001). Conclusions PAB before NP in high-risk patients constituted salvage management. Primary PAB provided enough time for stabilization and control of most risk factors. It allowed midterm survival equivalent to the survival after primary NP in lower risk neonates.

scholarly journals Central pulmonary artery growth patterns after the bidirectional Glenn procedure

1994 ◽  
Vol 107 (5) ◽  
pp. 1284-1290 ◽  
Author(s):  
Alan M. Mendelsohn ◽  
Edward L. Bove ◽  
Flavian M. Lupinetti ◽  
Dennis C. Crowley ◽  
Thomas R. Lloyd ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Growth Patterns ◽  
Bidirectional Glenn ◽  
Central Pulmonary Artery ◽  
Bidirectional Glenn Procedure ◽  
Glenn Procedure

Growth of children with a functionally single ventricle following palliation at moderately increased altitude

2000 ◽  
Vol 10 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Ronald W. Day ◽  
David M. Denton ◽  
W. Daniel Jackson
Keyword(s):  
Single Ventricle ◽  
Fontan Procedure ◽  
Response To Therapy ◽  
Z Score ◽  
Bidirectional Glenn ◽  
Rate Of Growth ◽  
Z Scores ◽  
Bidirectional Glenn Procedure ◽  
Glenn Procedure

AbstractThe bidirectional Glenn and Fontan procedures are empirically performed as interim and definitive procedures in children with a functionally single ventricle. The optimal stage of palliation, nonetheless, remains unknown. During childhood, growth is a fundamental measure of response to therapy. Growth may be influenced by the degree of cyanosis, the volume load on the ventricle, and cardiac performance. Thus, the weight and stature of children with a functionally single ventricle who underwent a bidirectional Glenn procedure or a Fontan procedure were studied to determine the effect of each intervention on growth. Z scores for weight and stature were retrospectively determined prior to palliation, at yearly intervals for 4 years, and from long-term measurements until 18 years of age in all patients with at least 2 years of observation following palliation. Growth was evaluated in 54 patients with a bidirectional Glenn procedure, and 65 patients with a Fontan procedure. The Z scores for weight were improved after each method of surgical palliation. Stature, however, was improved only following the bidirectional Glenn procedure. Growth was impaired in patients who developed protein losing enteropathy. Weight improved only during the initial 2 years after the Fontan procedure in patients who had a surgical fenestration. Over the long-term, patients who underwent a Fontan procedure were more likely to have a Z score less than −2.0 for weight and stature than patients who underwent only a bidirectional Glenn procedure. Late mortality and the incidence of heart transplantation were increased in patients who experienced a decrease in their rate of growth, defined as a negative change of more than one Z score in weight or stature, following the Fontan procedure. In conclusion, at moderately increased altitude, children with a functionally single ventricle grow more appropriately following the bidirectional Glenn procedure than following the Fontan procedure. A decrease in the rate of growth is associated with a poor prognosis following the Fontan procedure.

Sign in / Sign up

Export Citation Format

Share Document