BACKGROUND The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt...

Introduction Hypoplastic left heart syndrome (HLHS) describes a spectrum of left heart hypoplasias, which leave the left ventricle unable to support the systemic circulation. Staged palliation consists of aortic reconstruction and systemic to pulmonary artery shunt in the neonatal period (stage I), followed at intervals by superior (Stage II) and then total cavopulmonary connection (Stage III)....

Dependence on an expanded polytetrafluoroethylene graft for provision of pulmonary blood flow is a common yet precarious interval through which a population of patients with congenital heart disease must pass. The goals of the systemic-to–pulmonary artery shunt are to relieve cyanosis and to provide time before establishing in-series circulation by either complete repair of 2-ventricle lesions ...

In this report, we describe a case of multiple brain abscesses associated with diffuse congenital pulmonary arteriovenous malformations (PAVM). Although the cases of brain abscesses associated with congenital PAVM are very rare, the brain abscess could be an initial clinical manifestation in asymptomatic PAVM as in the case presented in this report. PAVM may contribute to the development of a b...

OBJECTIVES To determine the association between surgical management of pulmonary blood flow (PBF) at initial and staged procedures with survival to Fontan/Kreutzer operation (Fontan) in patients with tricuspid atresia. METHODS Infants aged <3 months with tricuspid atresia type I (n = 303) were enrolled from 34 institutions (1999-2013). Among those who underwent surgical intervention (n = 302)...

BACKGROUND We evaluated the hemodynamic status of patent ductus arteriosus (PDA) by measuring vena contracta width (VCW) and effective shunt orifice area (ESOA) using proximal isovelocity surface area (PISA) on color Doppler imaging. METHODS AND RESULTS: Study subjects were 21 patients with PDA (mean age, 3.6 years). We measured VCW (mm/m(2)) and ESOA (cm(2)) by the PISA method using echocardio...

The present series describes a group of adults with left-to-right shunts including partial anomalous pulmonary venous return (PAPVR) and/or an atrial septal defect (ASD) evaluated with ECG-gated 128-slice multidetector computed tomography (MDCT). PAPVR is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium. PAPVR involv...

OBJECTIVES Patients with pulmonary atresia and intact ventricular septum (PA-IVS) may have coronary sinusoids connected to a hypertensive right ventricle. Coronary perfusion may then completely depend on the right ventricular systolic pressure wave; decompression of the right ventricle can be deleterious in these patients. This study was set to investigate the treatment strategies and outcomes ...

The pulsed Doppler technique was used to record the flow velocity patterns in the ductus arteriosus and the pulmonary artery in 26 patients with either isolated or complicated patent ductus arteriosus (PDA). In all patients, abnormal Doppler signals indicating left-to-right (L-R) or right-to-left shunt flow or both could be obtained at the site of the ductus arteriosus. These Doppler flow patte...