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Pediatric Cardiology

, Volume 34, Issue 1, pp 112–118 | Cite as

Interventions After Norwood Procedure: Comparison of Sano and Modified Blalock–Taussig Shunt

  • Julia Fischbach
  • Nicodème Sinzobahamvya
  • Christoph Haun
  • Ehrenfried Schindler
  • Peter Zartner
  • Martin Schneider
  • Viktor Hraška
  • Boulos Asfour
  • Joachim PhotiadisEmail author
Original Article

Abstract

Improved results have evolved from the modified Norwood procedure (NP). This study compares the incidence of interventions after NP with the Sano (n = 37) and modified Blalock–Taussig (BT n = 70) shunt. Incidence, location, interval of interventions, and weight were retrospectively analysed for 107 neonates undergoing NP during the period from October 2002 to December 2009. Forty-six (43.0 %) patients underwent interventions, mostly for dilatation of the aortic arch ([DAA] n = 26 [24.3 %]; Sano n = 10, BT n = 16, p = 0.6), dilatation of the shunt ([DS] n = 15 [14.0 %]; Sano n = 11, BT n = 4; p = 0.002), or closure of aortopulmonary collaterals ([APC] n = 15 [14.0 %]; Sano n = 3, BT n = 12; p = 0.08). Mean interval after NP and body weight at DAA, DS, and APC were 72.4 ± 18.9, 108.5 ± 15.8, and 110.7 ± 17.8 days and 4.5 ± 1.3, 4.9 ± 1.9, 5.3 ± 1.2 kg, respectively. The interventions were not associated with mortality but with a greater rate of complications (9 of 46 [21.4 %]) compared with the rate after diagnostic catheterization (0 of 45, p = 0.03). Complications included closure of the femoral or subclavian artery (n = 5), cerebral embolic or bleeding events (n = 4), cardiopulmonary resuscitation (n = 3), and temporary heart block (n = 2). Actuarial survival was similar from the postoperative month 8 onward at 78.6 ± 4.9 % (95 % confidence interval [CI] 67.0–86.5 %) for Sano and 78.4 ± 6.8 % (95 % CI 61.4–88.6 %) for BT (p = 0.95). Interventions after NP were common irrespective of shunt type. However, a significantly greater rate of shunt interventions was noted in the Sano group. In particular, interventions addressing the aortic arch and the shunt were related with a significant rate of complications.

Keywords

Congenital heart disease Norwood operation Intervention Sano RV–PA shunt 

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Julia Fischbach
    • 1
  • Nicodème Sinzobahamvya
    • 1
  • Christoph Haun
    • 2
  • Ehrenfried Schindler
    • 3
  • Peter Zartner
    • 4
  • Martin Schneider
    • 4
  • Viktor Hraška
    • 1
  • Boulos Asfour
    • 1
  • Joachim Photiadis
    • 1
    Email author
  1. 1.Department of Pediatric Cardio-Thoracic Surgery, German Pediatric Heart Center (Deutsches Kinderherzzentrum)Asklepios Clinic Sankt AugustinSankt AugustinGermany
  2. 2.Department of Pediatric Cardiac Intensive Care, German Pediatric Heart Center (Deutsches Kinderherzzentrum)Asklepios Clinic Sankt AugustinSankt AugustinGermany
  3. 3.Department of Pediatric Cardiac Anaesthesiology, German Pediatric Heart Center (Deutsches Kinderherzzentrum)Asklepios Clinic Sankt AugustinSankt AugustinGermany
  4. 4.Department of Pediatric Cardiology, German Pediatric Heart Center (Deutsches Kinderherzzentrum)Asklepios Clinic Sankt AugustinSankt AugustinGermany

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