{"title":"内克尔医院改良的诺伍德手术:左心发育不全综合征的一期和二期","authors":"Margaux Pontailler, Régis Gaudin, Olivier Raisky","doi":"10.1053/j.optechstcvs.2022.04.009","DOIUrl":null,"url":null,"abstract":"<div><p>We describe a modified Stage I neonatal surgical palliation for hypoplastic left heart syndrome inspired by both the Norwood and hybrid procedures. This new technique consists in: (1) replacement of the patent ductus arteriosus and aortic arch plasty with a pulmonary homograft, (2) banding of both the right and left pulmonary arteries (PA), (3) atrial septectomy, and (4) reimplantation of the Aorta (when needed). This surgery is performed under cardio-pulmonary bypass without aortic cross clamping, except when the ascending Aorta is atretic and needs to be reimplanted. Stage II consists in the division of the pulmonary bifurcation, PA branch plasty (with debanding), bidirectional cavopulmonary shunt and Damus-Kaye-Stansel anastomosis. This new surgical procedure allowed us to obtain hemodynamically stable postoperative patients and decrease by twice our mortality rate after Stage I palliation in hypoplastic left heart syndrome but with frequent left PA stenosis or hypoplasia.</p></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"27 3","pages":"Pages 313-326"},"PeriodicalIF":0.0000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"The Modified Norwood Procedure at Necker Hospital: Stage I and II for Hypoplastic Left Heart Syndrome\",\"authors\":\"Margaux Pontailler, Régis Gaudin, Olivier Raisky\",\"doi\":\"10.1053/j.optechstcvs.2022.04.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>We describe a modified Stage I neonatal surgical palliation for hypoplastic left heart syndrome inspired by both the Norwood and hybrid procedures. This new technique consists in: (1) replacement of the patent ductus arteriosus and aortic arch plasty with a pulmonary homograft, (2) banding of both the right and left pulmonary arteries (PA), (3) atrial septectomy, and (4) reimplantation of the Aorta (when needed). This surgery is performed under cardio-pulmonary bypass without aortic cross clamping, except when the ascending Aorta is atretic and needs to be reimplanted. Stage II consists in the division of the pulmonary bifurcation, PA branch plasty (with debanding), bidirectional cavopulmonary shunt and Damus-Kaye-Stansel anastomosis. This new surgical procedure allowed us to obtain hemodynamically stable postoperative patients and decrease by twice our mortality rate after Stage I palliation in hypoplastic left heart syndrome but with frequent left PA stenosis or hypoplasia.</p></div>\",\"PeriodicalId\":35965,\"journal\":{\"name\":\"Operative Techniques in Thoracic and Cardiovascular Surgery\",\"volume\":\"27 3\",\"pages\":\"Pages 313-326\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Operative Techniques in Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S152229422200040X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Techniques in Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S152229422200040X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
The Modified Norwood Procedure at Necker Hospital: Stage I and II for Hypoplastic Left Heart Syndrome
We describe a modified Stage I neonatal surgical palliation for hypoplastic left heart syndrome inspired by both the Norwood and hybrid procedures. This new technique consists in: (1) replacement of the patent ductus arteriosus and aortic arch plasty with a pulmonary homograft, (2) banding of both the right and left pulmonary arteries (PA), (3) atrial septectomy, and (4) reimplantation of the Aorta (when needed). This surgery is performed under cardio-pulmonary bypass without aortic cross clamping, except when the ascending Aorta is atretic and needs to be reimplanted. Stage II consists in the division of the pulmonary bifurcation, PA branch plasty (with debanding), bidirectional cavopulmonary shunt and Damus-Kaye-Stansel anastomosis. This new surgical procedure allowed us to obtain hemodynamically stable postoperative patients and decrease by twice our mortality rate after Stage I palliation in hypoplastic left heart syndrome but with frequent left PA stenosis or hypoplasia.
期刊介绍：
Operative Techniques in Thoracic and Cardiovascular Surgery provides richly illustrated articles on techniques in thoracic and cardiovascular surgery written by renowned surgeons. Each issue presents cardiothoracic topics in adult cardiac, congenital, and general thoracic surgery. Each specialty of interest to the thoracic and cardiovascular surgeon is explored through two different approaches to a specific surgical challenge. Each article is thoroughly illustrated with original line drawings, actual intraoperative photos, and supporting tables and graphs.
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