[Results of Norwood type operation for interrupted aortic arch complex; surgical decision making]

Kyobu Geka. 2011 Aug;64(9):785-9; discussion 789-91.
[Article in Japanese]

Abstract

Background: Interrupted aortic arch (IAA) is associated with a multitude of lesions ranging from isolated ventricular septal defect to hypoplastic left ventricle or severe subaortic stenosis (SAS). Left ventricular outflow obstruction such as SAS continues to be an important factor for deciding the surgical procedure between univentricular and biventricular repairs.

Methods: A retrospective study was conducted in 8 consecutive infants aged 14 to 117 days and operated on between 2004 and 2009. Seven patients had undergone bilateral pulmonary artery banding for pulmonary high flow regulation. All patients underwent Norwood-type operation (4 with systemic to pulmonary artery shunt, 3 with right ventricle to pulmonary artery shunt, and 1 with bidirectional Glenn shunt).

Results: One patient died 2 months after surgery due to respiratory failure. The others were discharged in a good condition. One patient underwent Rastelli-type operation and biventricular circulation was achieved. The other 6 patients were all Fontan candidates.

Conclusion: Satisfactory initial palliation can be achieved by Norwood-type operation for IAA with severe SAS or hypoplastic left ventricular-aortic complex.

Publication types

  • English Abstract

MeSH terms

  • Aorta, Thoracic / abnormalities*
  • Aorta, Thoracic / surgery
  • Aortic Valve Stenosis / complications
  • Decision Making
  • Female
  • Humans
  • Hypoplastic Left Heart Syndrome / complications
  • Infant
  • Infant, Newborn
  • Male
  • Norwood Procedures*
  • Retrospective Studies
  • Treatment Outcome