Heart Transplantation of a Preterm Infant With HLHS

2021 ◽  
pp. 215013512097984
Author(s):  
Othman A. Aljohani ◽  
Duncan Mackie ◽  
Emily A. Fletcher ◽  
Katayoon Shayan ◽  
Gabrielle R. Vaughn ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Extracorporeal Membrane Oxygenation ◽  
Heart Transplantation ◽  
Weight Ratio ◽  
Hemodynamic Instability ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Bilateral Pulmonary Artery Banding ◽  
Left Heart Syndrome

A 33-week gestation, 1.75-kg female infant with mitral stenosis/aortic atresia variant of hypoplastic left heart syndrome and severe ventriculo-coronary connections underwent surgical septectomy and bilateral pulmonary artery banding at five weeks of age (2.10 kg). After separation from bypass, she developed hemodynamic instability requiring venoarterial extracorporeal membrane oxygenation support. She was listed for heart transplantation and transplanted after three days of support with an oversized heart (4.7:1 donor–recipient weight ratio).

scholarly journals Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome☆

2009 ◽  
Vol 36 (6) ◽  
pp. 973-979 ◽  
Author(s):  
Takahisa Sakurai ◽  
Hideaki Kado ◽  
Toshihide Nakano ◽  
Kazuhiro Hinokiyama ◽  
Akira Shiose ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Hypoplastic Left Heart Syndrome ◽  
Pulmonary Artery Banding ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Early Results ◽  
Bilateral Pulmonary Artery Banding ◽  
Left Heart Syndrome

scholarly journals Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome

Heart ◽  
2017 ◽  
Vol 104 (3) ◽  
pp. 244-252 ◽  
Author(s):  
Heiner Latus ◽  
Mohamed S Nassar ◽  
James Wong ◽  
Pauline Hachmann ◽  
Hannah Bellsham-Revell ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Hypoplastic Left Heart Syndrome ◽  
Hybrid Procedure ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Hybrid Strategy ◽  
Pump Function ◽  
Bilateral Pulmonary Artery Banding ◽  
Left Heart Syndrome ◽  
Hybrid Group

ObjectiveNorwood and hybrid procedure are two options available for initial palliation of patients with hypoplastic left heart syndrome (HLHS). Our study aimed to assess potential differences in right ventricular (RV) function and pulmonary artery dimensions using cardiac magnetic resonance (CMR) in survivors with HLHS.Methods42 Norwood (mean age 2.4±0.8) and 44 hybrid (mean age 2.0±1.0 years) patients were evaluated by CMR after stage II palliation prior to planned Fontan completion. Initial stage I Norwood procedure was performed using a modified Blalock-Taussig shunt, while the hybrid procedure consisted of bilateral pulmonary artery banding and arterial duct stenting. Need for reinterventions and subsequent outcomes were also assessed.ResultsNorwood patients had larger RV end-diastolic dimensions (91±23 vs 80±31 mL/m2, p=0.004) and lower heart rate (90±15 vs 102±13, p<0.001) than hybrid patients. Both Norwood and hybrid patients showed preserved global RV pump function (59±9 vs 59%±10%, p=0.91), while RV strain, strain rate and intraventricular synchrony were superior in the Norwood group. Pulmonary artery size was reduced (lower lobe index 135±74 vs 161±62 mm2/m2, p=0.02), and reintervention rate was significantly higher in the hybrid group whereas subsequent outcome did not differ significantly (p=0.24).ConclusionsNorwood and hybrid strategy were associated with equivalent and preserved global RV pump function while development of the pulmonary arteries and reintervention rate were superior using the Norwood approach. Impaired RV myocardial deformation as a potential marker of early RV dysfunction in the hybrid group may have a negative long-term impact in this population.

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