▫La cirugía busca minimizar los factores de riesgo que acechan al Norwood estadio I Fontan atriopulmonar: Conexión de AD con TP para q sangre de. The Fontan procedure or Fontan–Kreutzer procedure is a palliative surgical procedure used in from their existing blood supply (e.g. a shunt created during a Norwood procedure, a patent ductus arteriosus, etc.). Leval, Marc R de ( ). d Servicio de Cirugía Cardiovascular, Hospital Infantil Universitario Virgen del Between October and June , 42 children underwent the Norwood.
|Published (Last):||25 June 2016|
|PDF File Size:||9.51 Mb|
|ePub File Size:||8.86 Mb|
|Price:||Free* [*Free Regsitration Required]|
Síndrome del corazón izquierdo hipoplástico | American Heart Association
The Fontan procedure or Fontan—Kreutzer procedure is a palliative surgical procedure used in children with univentricular hearts. Please help improve this article by adding citations to reliable sources. The process of weaning off the respirator began once the norwwood was hemodynamicaly stable and when the thorax had been closed, in children with deferred closure.
Among the anatomical characteristics of the cardiopathy we emphasized that the average diameter of the ascending aorta was 3.
The P 50 of the ECC time, aortic clamping and circulatory shutdown was of It was initially described in by Dr. There are four variations of the Fontan procedure: All the analyses were made with SPSS software, version The mean age and the weight of them in the last review was 19 months range, and 9 kg range, 6.
In the short term, children can norwoood trouble with pleural effusions fluid building up around nrowood lungs.
The first 30 patients group 1 underwent the classic 1 Norwood technique, receiving a modified Cjrugia fistula of different diameters, and in the other 12 group 2 the Sano 4 variant was used.
To address this risk, some surgeons make a fenestration from the venous circulation into the atrium. Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan cirguia left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of great norwoodd Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock—Taussig shunt SVC to the right PA Glenn procedure.
Two of the patients who did not undergo the homograft had respiratory insufficiency after being weaned from mechanical ventilation, with an extrinsic compression of the pulmonary artery and left main bronchus by the neoaorta, demonstrated through an airway study.
In relation to the surgical technique, up until some years ago some authors 16 reconstructed the aortic arch without a homograft; in this way, it was thought, long term growth of the new aorta was benefited without any residual stenosis.
Heart valves and septa Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock—Taussig shunt SVC to the right PA Glenn procedure.
Experience With the Norwood Operation for Hypoplastic Left Heart Syndrome
The diagnosis was done in utero in eight patients. The intervention was made at an mean age of This procedure improves the growth of the pulmonary arteries with a more uniform distribution. The hypoplasic left heart syndrome is a cardiopathy with many anatomical variants that are frequently associated with other malformations or genetical alterations; its proper evaluation and presurgical diagnosis allows us to establish a prognosis, which is independent of the surgical technique and the postsurgical care.
Two cases had respiratory insufficiency that made weaning off ventilation difficult, finding a dynamic obstruction of the left main bronchus by means of fibrobronchoscopy.
Global hospital mortality was Cardiac surgery Congenital heart defects Pediatric surgical cirugiq Thoracic surgical procedures.
Fontan procedure – Wikipedia
The fraction of the pulmonary dead space is considered normal if between 0. The surgical technique used in them to reconstruct the aortic arc was the terminoterminal suture without aortic graft. Concerns about damage to the liver have emerged more recently, as Fontan circulation produces congestion and lymphedema in this organ which leads to progressive hepatic fibrosis. Mortality in the PICU was also greater, although the differences in this case were not significant Table 3.
Often, cardiac catheterization is performed to check the resistance before proceeding with the surgery. Fontan procedure is also contraindicated in those with pulmonary artery hypoplasia, patients with left ventricular dysfunction and significant mitral insufficiency.
Surgical treatment of the hypoplasic left heart syndrome has been a reason for worry among surgical teams due to its elevated mortality. Some of the quantitative variables did not follow a normal distribution test of Kolmogorov-Smirnovreason for which they were described as a mean interquartile range. This can require a longer stay in the hospital for drainage with chest tubes.
Nelson Textbook of Pediatrics 17th ed. This corrects the hypoxia and leaves the single ventricle responsible only for supplying blood to the body.
The second stage, also called Fontan completioninvolves redirecting the blood ed the IVC to the lungs.
The pulmonary flow is attained through a fistula between the aorta and the pulmonary artery. For this motive, and coinciding with the findings of previous studies, they have not been considered as prognostic factors for early mortality.
Images subject to Copyright. The hypoplasic left heart syndrome is a serious congenital cardiopathy that leads to surgery in the first days of life.
This experience has made us consider the possibility of using a homograft in a systematic manner, as is being done by other authors with good results, 12 to elevate the position of the aortic arch and reducing the possibility of compressing adjacent norrwood. In norwooe first 30 patients, pulmonary circulation was established using a modified Blalock-Taussig shunt Group 1while a right ventricle to pulmonary artery conduit was used in the remaining 12 Group 2.
We did not find significant differences between the mortality in the PICU and the surgical technique employed groups 1 and 2 Table 7probably due to the low number of patients currently included in group 2.