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Ann Thorac Surg 2005;80:1924-1928
© 2005 The Society of Thoracic Surgeons

Case report

Proximal Conduit Obstruction After Sano Modified Norwood Procedure

John J. Nigro, MD a , * , Robert D. Bart, MD b , Christopher D. Derby, MD a , Mark S. Sklansky, MD c , Vaughn A. Starnes, MD a

a Department of Cardiothoracic Surgery, Los Angeles, California, USA
b Department of Anesthesiology, Critical Care Medicine, Los Angeles, California, USA
c Division of Cardiology; Department of Pediatrics, Childrens Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA

Accepted for publication June 11, 2004.

* Address correspondence to Dr Nigro, Department of Cardiothoracic Surgery, Keck School of Medicine of the University of Southern California, Childrens Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 66, Los Angeles, CA90027 (Email: jnigro{at}usc.edu).

Sano and colleagues [1] recently described a modification of first stage palliation for hypoplastic left heart syndrome utilizing a right ventricle to pulmonary artery conduit. Preliminary results are favorable, but experience with this technique is limited. We report a case of sudden death due to obstruction of the proximal conduit by fibrointimal hyperplasia. This case of lethal conduit obstruction presented 3 months after initial palliation. Early cardiac catheterization and second stage palliation may be necessary to minimize the risk of such adverse events after the Sano modification.




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