Systemic Semilunar Valve Dysfunction May Be an Underappreciated Component of the Late Morbidity Occurring After Single Ventricle Palliation

2021 ◽  
Vol 12 (6) ◽  
pp. 745-746
Author(s):  
John Lamberti
Keyword(s):  
Single Ventricle ◽  
Semilunar Valve ◽  
Valve Dysfunction ◽  
Late Morbidity ◽  
Single Ventricle Palliation

scholarly journals Critical Ebstein’s anomaly with circular shunt: from successful fetal therapy with non-steroidal anti-inflammatory drugs to biventricular repair using Da Silva cone technique

2021 ◽  
pp. 1-4
Author(s):  
Lilian M. Lopes ◽  
Rodrigo F. Bezerra ◽  
Jose Pedro da Silva ◽  
Luciana da Fonseca da Silva
Keyword(s):  
Single Ventricle ◽  
Ductus Arteriosus ◽  
Ebstein’S Anomaly ◽  
Biventricular Repair ◽  
Fetal Demise ◽  
Ebstein's Anomaly ◽  
Gestational Week ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Single Ventricle Palliation

Abstract We report an innovative treatment strategy for fetal Ebstein’s anomaly with a circular shunt. We used transplacental non-steroidal anti-inflammatory drugs, at the 29th gestational week, to constrict the ductus arteriosus avoiding fetal demise. We addressed the critical neonate with an urgent Starnes procedure. Finally, instead of following the usual single-ventricle palliation pathway after the Starnes procedure, we achieved successful two-ventricle repair with the cone technique at 5 month old.

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

2019 ◽  
Vol 10 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Valdano Manuel ◽  
Humberto Morais ◽  
Aida L. R. Turquetto ◽  
Gade Miguel ◽  
Leonardo A. Miana ◽  
...  
Keyword(s):  
Confidence Interval ◽  
African Country ◽  
Single Ventricle ◽  
Hazard Ratio ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Lost To Follow Up ◽  
Single Ventricle Palliation

Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock–Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

scholarly journals MELD-XI SCORE AND FONTAN FAILURE IN PATIENTS WITH SINGLE VENTRICLE PALLIATION FOR COMPLEX CONGENITAL HEART DISEASE

2011 ◽  
Vol 57 (14) ◽  
pp. E409
Author(s):  
Gabriele Egidy Assenza ◽  
Kimberlee Gauvreau ◽  
Dionne Graham ◽  
Michael Job Landzberg ◽  
Koenraad J. Mortele ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Single Ventricle ◽  
Complex Congenital Heart Disease ◽  
Fontan Failure ◽  
Single Ventricle Palliation

Surgical management of symptomatic neonates with Ebstein’s anomaly: choice of operation

2014 ◽  
Vol 25 (6) ◽  
pp. 1119-1123 ◽  
Author(s):  
Christopher J. Knott-Craig ◽  
Thittamaranahalli Kariyappa S. Kumar ◽  
Alejandro R. Arevalo ◽  
Vijaya M. Joshi
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Surgical Management ◽  
Single Ventricle ◽  
Pulmonary Atresia ◽  
Early Mortality ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Single Ventricle Palliation ◽  
Artery Conduit

AbstractObjective:Symptomatic neonates with Ebstein’s anomaly pose significant challenge. Within this cohort, neonates with associated anatomical pulmonary atresia have higher mortality. We review our experience with this difficult subset.Methods:A total of 32 consecutive symptomatic neonates with Ebstein’s anomaly underwent surgical intervention between 1994 and 2013. Of them, 20 neonates (62%, 20/32) had associated pulmonary atresia. Patients’ weights ranged from 1.9 to 3.4 kg. All patients without pulmonary atresia had two-ventricle repair. Of the 20 neonates, 16 (80%, 16/20) with Ebstein’s anomaly and pulmonary atresia had two-ventricle repair and 4 had single-ventricle palliation, of which 2 underwent Starnes’ palliation and 2 Blalock–Taussig shunts. Six recent patients with Ebstein’s anomaly and pulmonary atresia had right ventricle to pulmonary artery valved conduit as part of their two-ventricle repair.Results:Overall early mortality was 28% (9/32). For those without pulmonary atresia, mortality was 8.3% (1/12). For the entire cohort of neonates with Ebstein’s anomaly and pulmonary atresia, mortality was 40% (8/20; p=0.05). Mortality for neonates with Ebstein’s anomaly and pulmonary atresia having two-ventricle repair was 44% (7/16). Mortality for neonates with Ebstein’s anomaly and pulmonary atresia having two-ventricle repair utilising right ventricle to pulmonary artery conduit was 16% (1/6). For those having one-ventricle repair, the mortality was 25% (1/4).Conclusions:Surgical management of neonates with Ebstein’s anomaly remains challenging. For neonates with Ebstein’s anomaly and anatomical pulmonary atresia, single-ventricle palliation is associated with lower early mortality compared with two-ventricle repair. This outcome advantage is negated by inclusion of right ventricle to pulmonary artery conduit as part of the two-ventricle repair.

scholarly journals Echocardiographic preoperative evaluation of unbalanced atrioventricular septal defect

2020 ◽  
Vol 26 (2) ◽  
pp. 46-58
Author(s):  
Zornitsa Vassileva ◽  
Anna Kaneva
Keyword(s):  
Congenital Heart ◽  
Septal Defect ◽  
Single Ventricle ◽  
Preoperative Evaluation ◽  
Atrioventricular Septal Defect ◽  
Precise Determination ◽  
Moderate Degree ◽  
Surgical Strategies ◽  
Single Ventricle Palliation

Unbalanced atrioventricular septal defect is seen by 10-15% of the patients with this congenital heart disease and poses serious challenges for the treating physicians regarding the choice of the most suitable operative intervention. The forms with moderate degree of unbalance between the two ventricles, especially when the size of the left ventricle is considered borderline, make the choice between two-ventricle correction and single-ventricle palliation quite difficult. The most important factor when judging the degree of unbalance is not the size of the ventricles but rather the redistribution of blood flow. The use of different echocardiographic measurements could contribute to the more precise determination of the indications for one of the two surgical strategies with resulting improvement of patient outcome.

Pre‐ and post‐operative cardiovascular CT in Stage I single ventricle palliation

2021 ◽  
Author(s):  
Sheba John ◽  
Laura Schoeneberg ◽  
Christopher E. Greenleaf ◽  
Jorge D. Salazar ◽  
Dilachew A. Adebo
Keyword(s):  
Single Ventricle ◽  
Stage I ◽  
Single Ventricle Palliation ◽  
Cardiovascular Ct
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