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Use of a saphenous venous homograft for constructing a conduit from the right ventricle to the pulmonary arteries in the Norwood procedure

  • Luca A. Vricella (a1), Jane E. Crosson (a2) and Duke E. Cameron (a1)

Abstract

The use of a conduit of polytetrafluoroethylene placed between the right ventricle and the pulmonary arteries as source of pulmonary arterial supply during the first stage of palliation for the hypoplastic left heart syndrome has facilitated post-operative management and resulted in decreased mortality. We describe here the use of a cryopreserved saphenous vein inserted in reversed direction to create the connection between the right ventricle and the pulmonary arteries in a neonate with low birth weight undergoing the modified Norwood procedure.

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Corresponding author

Correspondence to: Luca Vricella MD, Division of Cardiac Surgery, The Johns Hopkins Hospital, 600 N. Wolfe Street – Blalock 618, Baltimore, MD 21287-4618, USA Tel: +1 (443) 955 3809; E-mail: lvricella@jhmi.edu

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References

Norwood WI, Lang P, Hansen DD. Physiologic repair of aortic atresia-hypoplastic left heart syndrome. New Engl J Med 1983; 308: 2326.
Sano S, Ishino K, Kawada M, et al. Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg 2003; 126: 504510.
Pizarro C, Malec E, Mahler KO, et al. Right ventricle to pulmonary artery conduit improves outcome after stage I Norwood for hypoplastic left heart syndrome. Circulation 2003; 108 (Suppl II): II155II160.
Pizarro C, Januszewska K, Malec E, et al. Stage I Norwood with a right ventricle to pulmonary artery conduit provides appropriate preparation for a successful cavo-pulmonary connection. Proceedings from the 2nd Joint meeting of the European Association of Cardiothoracic Surgeons and the European Society of Thoracic Surgeons, Vienna, Austria, 1215 October 2003.
Murakami A, Takamoto S, Takaoka T, et al. Saphenous vein homograft containing a valve as a right ventricle-pulmonary artery conduit in the modified Norwood operation. J Thorac Cardiovasc Surg 2002; 124: 10411042.
Bogats G, Kertesz E, Toszegi A, Kovacs GS. Modified Blalock–Taussig shunt using allograft saphenous vein: six years’ experience. Ann Thorac Surg 1996; 61: 5862.
Tam VK, Murphy K, Parks J, et al. Saphenous vein homograft: a superior conduit for the systemic arterial shunt in the Norwood operation. Ann Thorac Surg 2001; 71: 15371540.
Bartram U, Grunenfelder J, Van Praagh R. Causes of death after the modified Norwood procedure: a study of 122 postmortem cases. Ann Thorac Surg 1997; 64: 17951802.

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