| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 1997;113:718-727
© 1997 Mosby, Inc.
SURGERY FOR CONGENITAL HEART DISEASE |
Received for publication July 25, 1996 revisions requested Sept. 3, 1996; revisions received Sept. 19, 1996 accepted for publication Sept. 23, 1996. Address for reprints: Mark A. Fogel, MD, The Children's Hospital of Philadelphia, Division of Cardiology–Heart Station, 34th St. and Civic Center Blvd., Philadelphia, PA 19104.
Abstract
Objectives: The objectives of this study were to define physiologic effects on and a clinical correlate to coronary blood flow during volume unloading surgery in patients with aortic atresia.
Methods: Twenty-two patients with aortic atresia (group I, 13 patients with stage I reconstruction undergoing hemi-Fontan operation; group II, 9 patients with hemi-Fontan undergoing Fontan operation) underwent perioperative transesophageal echocardiography. Doppler spectral patterns, peak velocity, velocity time integral, and blood flow in the native ascending aorta were measured. Preoperative hemodynamics and postoperative clinical data were analyzed. Significance was defined as p < 0.05.
Results: Higher values of coronary blood flow (982.9 ± 321.7 vs 548.6 ± 333.8 ml/min per square meter), velocity time integral (20.7 ± 5.6 vs 12.6 ± 4.0 cm), and peak velocity (96.1 ± 21.4 vs 51.0 ± 18.2 cm/sec) were found before operation in group I than after operation and in group II at both times. Flow changed from predominately systolic in preoperative group I to both systolic and diastolic after operation and in group II. Before operation in groups I and II, a number of hemodynamic parameters such as superior vena cava oxygen saturation correlated with coronary blood flow dynamics. After operation in group II, urine output (r = 0.86) and central venous pressure (r = -0.85) correlated with coronary blood flow dynamics.
Conclusion: Coronary blood flow parameters were higher in group I as a result of the increased energy needs required to pump to two circulations. No changes were found in group II. A number of coronary blood flow parameters correlated with preoperative hemodynamics and postoperative clinical data. These parameters appear to be useful in assessing the performance status of the myocardium after the Fontan operation, consistent with the notion that myocardial perfusion relates directly to ventricular function.
This article has been cited by other articles:
|
|
 |
|
  J. Cleuziou, C. Schreiber, J. K. Cornelsen, J. Horer, A. Eicken, and R. Lange Bidirectional cavopulmonary connection without additional pulmonary blood flow in patients below the age of 6 months Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 556 - 562. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Glatz, R. T. Fedderly, N. S. Ghanayem, and J. S. Tweddell Impact of mitral stenosis and aortic atresia on survival in hypoplastic left heart syndrome. Ann. Thorac. Surg., June 1, 2008; 85(6): 2057 - 2062. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. H. Aburawi, A. Berg, P. Liuba, and E. Pesonen Effects of cardiopulmonary bypass surgery on coronary flow in children assessed with transthoracic Doppler echocardiography Am J Physiol Heart Circ Physiol, August 1, 2007; 293(2): H1138 - H1143. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Ilbawi, D. E. Spicer, S. Bharati, A. Cook, and R. H. Anderson Morphologic study of the ascending aorta and aortic arch in hypoplastic left hearts: Surgical implications J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 99 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ricci, P. Lombardi, A. Galindo, S. Schultz, A. Vasquez, and E. Rosenkranz Effects of single-ventricle physiology with aortopulmonary shunt on regional myocardial blood flow in a piglet model. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 252 - 259.e2. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Takabayashi, H. Kado, Y. Shiokawa, K. Fukae, and T. Nakano Comparison of hemodynamics between Norwood procedure and systemic-to-pulmonary artery shunt for single right ventricle patients Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 968 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Simsic, A. Cuadrado, P. M. Kirshbom, K. R. Kanter, D. Ramaswamy, M. Clabby, and J. M. Forbess Novel management strategy for severe cyanosis after Sano modification of the Norwood procedure J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1450 - 1451. [Full Text] [PDF]
|
|
|
|
|
|
C. Pizarro, T. Mroczek, E. Malec, and W. I. Norwood Right Ventricle to Pulmonary Artery Conduit Reduces Interim Mortality After Stage 1 Norwood for Hypoplastic Left Heart Syndrome Ann. Thorac. Surg., December 1, 2004; 78(6): 1959 - 1964. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. B. Jaquiss, N. S. Ghanayem, G. M. Hoffman, R. T. Fedderly, J. R. Cava, K. A. Mussatto, and J. S. Tweddell Early cavopulmonary anastomosis in very young infants after the Norwood procedure: Impact on oxygenation, resource utilization, and mortality J. Thorac. Cardiovasc. Surg., April 1, 2004; 127(4): 982 - 989. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R E Andrews, R M R Tulloh, D R Anderson, and S B Lucas Acute myocardial infarction as a cause of death in palliated hypoplastic left heart syndrome Heart, April 1, 2004; 90(4): e17 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Rodefeld, J. H. Boyd, C. D. Myers, R. G. Presson Jr, W. W. Wagner Jr, and J. W. Brown Cavopulmonary assist in the neonate: an alternative strategy for single-ventricle palliation J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 705 - 711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. T. Mahle, A. R. Cuadrado, and V. K. H. Tam Early experience with a modified norwood procedure using right ventricle to pulmonary artery conduit Ann. Thorac. Surg., October 1, 2003; 76(4): 1084 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Pizarro, E. Malec, K. O. Maher, K. Januszewska, S. S. Gidding, K. A. Murdison, J. M. Baffa, and W. I. Norwood Right Ventricle to Pulmonary Artery Conduit Improves Outcome After Stage I Norwood for Hypoplastic Left Heart Syndrome Circulation, September 9, 2003; 108(90101): II-155 - 160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Pizarro and W. I. Norwood Right ventricle to pulmonary artery conduit has a favorable impact on postoperative physiology after Stage I Norwood: preliminary results Eur. J. Cardiothorac. Surg., June 1, 2003; 23(6): 991 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Ashburn, B. W. McCrindle, C. I. Tchervenkov, M. L. Jacobs, G. K. Lofland, E. L. Bove, T. L. Spray, W. G. Williams, and E. H. Blackstone Outcomes after the Norwood operation in neonates with critical aortic stenosis or aortic valve atresia J. Thorac. Cardiovasc. Surg., May 1, 2003; 125(5): 1070 - 1082. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Jacobs Aortic reconstruction in hypoplastic left heart syndrome--A reappraisal J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(90030): S82 - 84. [Full Text] [PDF]
|
|
|
|
|
|
W. T. Mahle, T. L. Spray, J. W. Gaynor, and B. J. Clark III Unexpected death after reconstructive surgery for hypoplastic left heart syndrome Ann. Thorac. Surg., January 1, 2001; 71(1): 61 - 65. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Abdullah, G. S. Van Arsdell, L. K. Hornberger, and I. Adatia Precoronary stenosis after stage I palliation for hypoplastic left heart syndrome Ann. Thorac. Surg., December 1, 2000; 70(6): 2147 - 2149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Jacobs Editorial: Aortic reconstruction in hypoplastic left heart syndrome--A reappraisal J. Thorac. Cardiovasc. Surg., November 1, 2000; 120(5): 872 - 874. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
