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Hypoplastic left heart syndrome: hemodynamic and angiographic assessment after initial reconstructive surgery and relevance to modified Fontan procedure.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Farrell, Pat Baffa, Jeanne Marie Barber, Gerald |
| Copyright Year | 1991 |
| Abstract | After undergoing initial reconstructive surgery for hypoplastic left heart syndrome performed between August 1985 and March 1989, 59 patients (age range 3 to 27 months, mean 13.8 +/- 4.5) underwent elective cardiac catheterization in anticipation of a modified Fontan procedure. Five important hemodynamic and anatomic features considered to be components of successful reconstructive surgery were specifically addressed. 1) Interatrial communication: Only two patients had a measured pressure difference of greater than 4 mm Hg across the atrial septum. 2) Tricuspid valve function: Angiography demonstrated significant tricuspid valve regurgitation in only five patients (moderate in two and severe in three). 3) Aortic arch: Pressure tracings from the right ventricle to the descending aorta revealed a gradient greater than 25 mm Hg in only two patients. 4) Pulmonary vasculature: Ten patients had a calculated pulmonary vascular resistance greater than 4 U.m2; 51 (86%) of the 59 patients had no evidence of distortion (stenosis or hypoplasia) of either the left or the right pulmonary artery. 5) Right ventricular function: Five patients had an end-diastolic pressure in the right ventricle greater than 12 mm Hg and two patients had qualitative assessment of decreased ventricular function. Comparison of catheterization data between survivors and nonsurvivors of the subsequent modified Fontan procedure showed that only significant tricuspid regurgitation is a possible predictor of poor outcome. After first stage reconstructive surgery for hypoplastic left heart syndrome, most survivors have favorable anatomy and hemodynamics at follow-up cardiac catheterization for a subsequent Fontan procedure. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://www.onlinejacc.org/content/accj/17/5/1143.full.pdf |
| PubMed reference number | 2007715v1 |
| Volume Number | 17 |
| Issue Number | 5 |
| Journal | Journal of the American College of Cardiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anatomic structures Blood supply aspects Descending aorta Diastole Diastolic blood pressure Dietary Mercury Fifty Nine Fontan Procedure Heart Atrium Heart Ventricle Hypoplastic Left Heart Syndrome Idiopathic Pulmonary Fibrosis Interatrial septum Kidney Failure, Chronic Left side of heart Operative Surgical Procedures Patients Pulmonary artery structure Reconstructive Surgical Procedures Regurgitation Right ventricular structure Stage level 1 Stenosis Survivors Tricuspid Valve Insufficiency Ventricular Function hemodynamics (procedure) |
| Content Type | Text |
| Resource Type | Article |
