Skip to main content

Advertisement

SpringerLink
Log in

Interventions Complementing Surgery as Part of Multistage Treatment for Hypoplastic Left Heart Syndrome: One Center’s Experience

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Background Interventional procedures often are used as part of multistage treatment for hypoplastic left heart syndrome (HLHS). This study aimed to evaluate the efficacy of interventions in multistage treatment of HLHS. Methods and Results Between 1999 and 2007, 78 interventions were performed for 58 children with HLHS at different stages of surgical treatment. Group 1, involving 30 interventions for 22 patients with postoperative pulmonary arterial stenosis, showed reduced pulmonary artery pressure and increased vessel diameter. Group 2, involving 15 interventions after the Norwood operation for 12 patients with aortic arch obstruction, showed success for 11 patients. Group 3, involving eight balloon angioplasties of narrowed Glenn anastomosis for seven patients, showed abolition of the pressure gradient between the superior vena cava and the right pulmonary artery. Group 4, involving eight interventional closures of a fenestration for eight patients after a Fontan operation, showed increased oxygen saturation for all eight patients. Group 5, involving seven interventions for six patients in whom venovenous collaterals were closed percutaneously, showed improved oxygen saturation. For Group 6, uncommon miscellaneous interventions were used to stabilize the patients’ condition before the next surgical treatment. Conclusions Interventional procedures play an important role during multistage treatment of HLHS. They allow for a reduction in the number of operations or stabilization of the patients’ condition before the next surgical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Chan KC, Mashburn C, Boucek MM (2006) Initial transcatheter palliation of hypoplastic left heart syndrome. Catheter Cardiovasc Interv 68:719–726

    Article  PubMed  CAS  Google Scholar 

  2. Chang AC, Farrell PE Jr, Murdison KA et al (1991) Hypoplastic left heart syndrome: hemodynamic and angiographic assessment after initial reconstructive surgery and relevance to modified Fontan procedure. J Am Coll Cardiol 17:1143–1149

    Article  PubMed  CAS  Google Scholar 

  3. Chau AK, Leung MP (1997) Management of branch pulmonary artery stenosis: balloon angioplasty or endovascular stenting. Clin Exp Pharmacol Physiol 24:960–962

    Article  PubMed  CAS  Google Scholar 

  4. Chessa M, Dindar A, Vettukattil JJ et al (2000) Balloon angioplasty in infants with aortic obstruction after the modified stage I Norwood procedure. Am Heart J 140:227–231

    Article  PubMed  CAS  Google Scholar 

  5. Cowley CG, Badran S, Gaffney D et al (2000) Transcatheter closure of Fontan fenestrations using the Amplatzer septal occluder: initial experience and follow-up. Catheter Cardiovasc Interv 51:301–304

    Article  PubMed  CAS  Google Scholar 

  6. Dahnert I, Riede FT, Razek V et al (2007) Catheter interventional treatment of Sano shunt obstruction in patients following modified Norwood palliation for hypoplastic left heart syndrome. Clin Res Cardiol 96:719–722

    Article  PubMed  CAS  Google Scholar 

  7. Douglas WI, Goldberg CS, Mosca RS et al (1999) Hemi-Fontan procedure for hypoplastic left heart syndrome: outcome and suitability for Fontan. Ann Thorac Surg 68:1361–1367

    Article  PubMed  CAS  Google Scholar 

  8. Duke C, Rosenthal E, Qureshi SA (2003) The efficacy and safety of stent redilatation in congenital heart disease. Heart 89:905–912

    Article  PubMed  CAS  Google Scholar 

  9. Fogelman R, Nykanen D, Smallhorn JF et al (1995) Endovascular stents in the pulmonary circulation: clinical impact on management and medium-term follow-up. Circulation 92:881–885

    PubMed  CAS  Google Scholar 

  10. Galantowicz M, Cheatham JP (2005) Lessons learned from the development of a new hybrid strategy for the management of hypoplastic left heart syndrome. Pediatr Cardiol 26:190–199

    Article  Google Scholar 

  11. Gaynor JW, Bridges ND, Cohen MI et al (2002) Predictors of outcome after the Fontan operation: is hypoplastic left heart syndrome still a risk factor? J Thorac Cardiovasc Surg 123:237–245

    Article  Google Scholar 

  12. Gewillig M, Boshoff D, Mertens L (2001) Creation with a stent of unrestrictive lasting atrial communication. Cardiol Young 12:408–411

    Google Scholar 

  13. Gutgesell HP, Lim DS (2007) Hybrid palliation in hypoplastic left heart syndrome. Curr Opin Cardiol 22:55–59

    Article  PubMed  Google Scholar 

  14. Ing FF, Grifka RG, Nihill MR, Mullins CE (1995) Repeat dilatation of intravascular stents in congenital heart defects. Circulation 92:893–897

    PubMed  CAS  Google Scholar 

  15. Kats S, de Jong PL, Witsenburg M, Bogers AJ (2006) Massive haemorrhage at resternotomy after stent implantation in ventriculopulmonary shunt after Norwood procedure. Interact Cardiovasc Thorac Surg 5:234–235

    Article  PubMed  Google Scholar 

  16. O’Laughlin MP, Perry SB, Lock JE, Mullins CE (1991) Use of endovascular stents in congenital heart disease. Circulation 83:1923–1939

    PubMed  CAS  Google Scholar 

  17. Pass RH, Hsu DT, Garabedian CP et al (2002) Endovascular stent implantation in the pulmonary arteries of infants and children without the use of a long vascular sheath. Catheter Cardiovasc Interv 55:505–509

    Article  PubMed  Google Scholar 

  18. Pedra CA, Neves JR, Pedra SR et al (2007) New transcatheter techniques for creation or enlargement of atrial septal defects in infants with complex congenital heart disease. Catheter Cardiovasc Interv 70:731–739

    Article  PubMed  Google Scholar 

  19. Rueda F, Squitieri C, Ballerini L (2001) Closure of the fenestration in the extracardiac Fontan with the Amplatzer duct occluder device. Catheter Cardiovasc Interv 54:88–92

    Article  PubMed  CAS  Google Scholar 

  20. Rupp S, Michel-Behnke I, Valeske K et al (2007) Implantation of stents to ensure an adequate interatrial communication in patients with hypoplastic left heart syndrome. Cardiol Young 17:535–540

    Article  PubMed  Google Scholar 

  21. Shaffer KM, Mullins CE, Grifka RG et al (1998) Intravascular stents in congenital heart disease: short- and long-term results from a large single-center experience. J Am Coll Cardiol 31:661–667

    Article  PubMed  CAS  Google Scholar 

  22. Soongswang J, McCrindle BW, Jones TK et al (2001) Outcomes of transcatheter balloon angioplasty of obstruction in the neo-aortic arch after the Norwood operation. Cardiol Young 11:54–61

    PubMed  CAS  Google Scholar 

  23. Stumper O, Gewillig M, Vettukattil J et al (2003) Modified technique of stent fenestration of the atrial septum. Heart 89:1227–1230

    Article  PubMed  CAS  Google Scholar 

  24. Tofeig M, Walsh KP, Chan C et al (1998) Occlusion of Fontan fenestrations using the Amplatzer septal occluder. Heart 79:368–370

    PubMed  CAS  Google Scholar 

  25. Trerotola SO, Lund GB, Newman J et al (1994) Repeat dilatation of Palmaz stents in pulmonary arteries: study of safety and effectiveness in a growing animal model. J Vasc Intervent Radiol 5:425–432

    Article  CAS  Google Scholar 

  26. Tworetzky W, McElhinney DB, Burch GH et al (2000) Balloon arterioplasty of recurrent coarctation after the modified Norwood procedure in infants. Catheter Cardiovasc Interv 50:54–58

    Article  PubMed  CAS  Google Scholar 

  27. Ungerleider RM, Johnston TA, O’Laughlin MP et al (2001) Intraoperative stents to rehabilitate severely stenotic pulmonary vessels. Ann Thorac Surg 71:476–481

    Article  PubMed  CAS  Google Scholar 

  28. Zeltser I, Menteer J, Gaynor JW et al (2005) Impact of re-coarctation following the Norwood operation on survival in the balloon angioplasty era. J Am Coll Cardiol 45:1844–1848

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Rzgowska, 281/289, Poland

    T. Moszura, A. Mazurek-Kula, P. Dryzek, J. A. Moll & A. Sysa

  2. Department of Cardiosurgery, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Rzgowska, 281/289, Poland

    J. J. Moll

  3. Evelina Children’s Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    S. A. Qureshi

Authors
  1. T. Moszura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Mazurek-Kula
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Dryzek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. J. Moll
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. A. Moll
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Sysa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. A. Qureshi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Moszura.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Moszura, T., Mazurek-Kula, A., Dryzek, P. et al. Interventions Complementing Surgery as Part of Multistage Treatment for Hypoplastic Left Heart Syndrome: One Center’s Experience. Pediatr Cardiol 30, 106–113 (2009). https://doi.org/10.1007/s00246-008-9283-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-008-9283-3

Keywords

Search

Navigation