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NORWOOD-YASUI OPERATION TO BYPASS THE SEVERE OBSTRUCTIVE OF LEFT VENTRICULAR OUTFLOW TRACT IN PATIENTS WITH INTERRUPTED AORTIC ARCH-VENTRICULAR SEPTAL DEFECT
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Abstract
Objective: To evaluate the primary outcomes of Norwood-Yasui operation for patients diagnosed with interrupted aortic arch-ventricular septal defect and severe left ventricular outflow tract obstruction at Heart Center, Vietnam National Children Hospital. Methods: From May 2012 to February 2022, 8 patients who underwent Norwood operation or Yasui procedure for left ventricular outflow tract bypass were retrospectively reviewed. Results: The median age and median weight of patients at the primary repair were 30.5 days (IQR, 21.5-37.5 days) and 3.15 kg (IQR, 2.7-3.8 kg). The mean time for bypass, aortic cross-clamp time, and selective regional cerebral perfusion time were 146.6 ± 25.1 minutes, 99.4 ± 21.2 minutes, and 47.4 ± 8.9 minutes, respectively. The median time for ventilation and hospital stays were 171 hours (IQR, 141.5 – 238 hours) and 29.5 days (IQR, 19.5 – 34.5 days). There were two patients died in hospital after Norwood operation. One patient underwent primary Yasui operation, and there were 4 patients who underwent biventricular repair as the second operation at the last follow-up (2 patients had Ross-Konno operation, 1 patient have Yasui procedure, and 1 patient underwent ventricular septal defect closure and resection of the conus septum), 1 patient who have Gleen operation and now waiting for biventricular repair. Conclusions: Staged repair for patients with severe left ventricular outflow tract obstruction-interrupted aortic arch-ventricular septal defect is reasonable and feasible for this complex congenital heart defect. Close follow-up in this specific group is essential to maintain survival and good outcomes.
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Keywords
interrupted aortic arch, severe left ventricular outflow tract obstruction, Norwood operation, Yasui procedure.
References
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