Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience Hipoplastik sol kalp sendromunda Norwood işleminin sonuçları: 12 yıllık tek merkezli deneyimimiz
Turkish Journal of Thoracic and Cardiovascular Surgery, cilt.30, sa.1, ss.26-35, 2022 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 1
- Basım Tarihi: 2022
- Doi Numarası: 10.5606/tgkdc.dergisi.2022.22397
- Dergi Adı: Turkish Journal of Thoracic and Cardiovascular Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.26-35
- Anahtar Kelimeler: Hypoplastic left heart syndrome, inter-stage mortality, Norwood procedure
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: In this study, we aimed to analyze the predictors and risk factors of mortality in patients who underwent Norwood I procedurewith the diagnosis of hypoplastic left heart syndrome.Methods: Between January 2009 and December 2020, a total of139 patients (95 males, 44 females) who underwent Norwood I procedurewith the diagnosis of hypoplastic left heart syndrome in our center wereretrospectively analyzed.Results: The median birth weight was 3,200(range, 3,000 to 3,350) g and the median age at the time of operationwas seven (range, 5 to 10) days. Pulmonary flow was achieved witha Sano shunt in the majority (72%) of patients. Survival rate was41% after the first stage. Reoperation for bleeding (p=0.017),reoperation for residual lesion (p=0.011), and postoperative peaklactate level (p=0.029), were associated with in-hospital mortality.Nineteen (33%) of 57 patients died before the second stage.Thirty-three (58%) patients underwent second stage, and survivalafter the second stage was 94%. Thirteen patients underwentthird stage, and survival after the third stage was 85%. Estimatedprobability of survival at six months, and one, two, three, and fouryears were 33%, 33%, 25%, 25%, and 22% respectively.Conclusion: Hospital and inter-stage mortality rates are still high andthis seems to be the most challenging period in term of survival effortsof the patients with hypoplastic left heart syndrome. Early recognitionand reintervention of anatomical residual defects, close follow-up in theinter-stage period, and the accumulation of multidisciplinary experiencemay help to improve the results to acceptable limits