• Title/Summary/Keyword: Norwood procedure

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Low Cardiac Output after Division of the Left Superior Vena Cava during a Norwood Operation for Hypoplastic Left Heart Syndrome in a Patient with Coronary Sinus Orifice Atresia -A case report- (관상정맥동 유입부 폐쇄를 동반한 좌심형성부전 증후군 환자의 Norwood 수술 중 좌상대정맥 절단 후 발생한 저박출증 - 1예 보고 -)

  • Choi, Eun-Seok;Kim, Woong-Han;Park, Sung-Joon;Kwak, Jae-Gun;Seo, Jeong-Wook
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.161-163
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    • 2010
  • A 12-day-old female baby underwent a Norwood procedure for hypoplastic left heart syndrome. The left superior vena cava (LSVC), which was found incidentally during the operation, was divided to facilitate surgical exposure. After the operation, she developed signs of low cardiac output and died 7 hours afterward. Autopsy findings showed that the coronary sinus was atretic at the orifice without unroofing into both atria, rendering the LSVC the sole route of coronary sinus drainage. In patients with incidentally-found LSVC during surgery, special care should be taken to leave the LSVC intact because the LSVC may be the exclusive drainage vein of the coronary venous system.

Hypoplastic Left Heart Syndrome - Experience in one Patient - (좌심저형성 증후군 경험 1)

  • 장봉현
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.404-410
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    • 1987
  • An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

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Hybrid Palliation for Functionally Single Ventricle with Systemic Outflow Obstruction (단심증에서의 Hybrid 고식술)

  • Cho, Won-Chul;Song, Kwang-Jae;Jung, Sung-Ho;Kim, Young-Hwee;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.927-930
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    • 2006
  • Hybrid procedure was performed for a thirteen-day-old girl with a functionally single ventricle, who weighed 2.2 kg and had been prematurely born at $32^{+5}$ weeks of gestation. She underwent bilateral pulmonary artery banding using 3.5 mm Gore-Tex graft, ductal stenting using balloon expandable stent, and reverse Blalock-Taussig shunt with 3.5 mm Gore-Tex vascular graft. After discharge, she was followed up for 4 months, and underwent 2nd stage operation(extensive arch reconstruction with Damus-Kaye-Stansel anastomosis, atrial septectomy, bilateral pulmonary artery angioplasty, bidirectional cavopulmonary shunt). She has been followed up for 4 months after the 2nd operation with an excellent clinical condition.

Revision Anterior Cruciate Ligament Surgery Using Hamstring Autograft (슬괵건을 이용한 전방 십자 인대 재 재건술)

  • In Yong;Bahk Won-Jong;Kwon Oh-Soo;Suh Young-Wan;Im Dong-Sun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.183-188
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    • 2003
  • Purpose : The purpose of this study is to evaluate the results of revision surgery for failed anterior cruciate ligament (ACL) reconstruction using quadruple hamstring tendon autograft. Materials and Methods : From May 2000 to July 2002, six patients received ACL revision surgery using quadruple hamstring autograft for failed ACL reconstruction. Femoral tunnels were made 40 mm in depth and fixed with a cross pin and a bioabsorbable interference screw to fill the bone defect. In tibial tunnels, the grafts were fixed with Intrafix(Mitek, Norwood, MA). In case of tibial tunnel widening, additional screw-washer fixation was done. Follow up was at least 12 months postoperatively. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee(IKDC) evaluation form and manual maximal side to side difference using KT-2000 arthrometer. Results : The average Lysholm knee score improved from 77.2 preoperatively to 87.7 postoperatively. At the final IKDC evaluation, 1 case was graded as normal, 4 nearly normal, 1 abnormal. Mean side to side difference of manual maximum anterior displacement using the KT-2000 arthrometer was 1.8mm. The success rate was $83\%$. Conclusion : ACL revision surgery using quadruple hamstring autograft with double fixation is considered good procedure with successful results.

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