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Right arrow Congenital - cyanotic

Ann Thorac Surg 2004;78:1090-1093
© 2004 The Society of Thoracic Surgeons

Case report

Comparison of right ventricle to pulmonary artery conduit and modified Blalock-Taussig shunt hemodynamics after the Norwood operation

Richard G. Ohye, MDa,*, Achiau Ludomirsky, MDb, Eric J. Devaney, MDa, Edward L. Bove, MDa,b

a Department of Surgery, Section of Cardiac Surgery, Ann Arbor, Michigan USA
b Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA

Accepted for publication June 25, 2003.

* Address reprint requests to Dr Ohye, F7830 Mott, 0223, 1500 East Medical Center Dr, Ann Arbor, MI 48109, USA
ohye{at}umich.edu

The Norwood procedure remains one of the highest-risk operations in congenital heart surgery. A significant contributor to this risk is thought to be the diastolic run-off into the modified Blalock-Taussig shunt (MBTS). In an effort to eliminate this risk, several groups have begun to utilize a right ventricle to pulmonary artery conduit (RVPAC), which decreases this diastolic "steal" of coronary blood flow. Whereas initial results with the RVPAC are encouraging, the postulated hemodynamic advantages are unproven. This case illustrates the positive hemodynamic changes by echocardiography after the replacement of a MBTS with a RVPAC in a patient after a Norwood procedure.




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