ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2010;89:168-173. doi:10.1016/j.athoracsur.2009.09.032
© 2010 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Yuji Naito
Mitsuru Aoki
Manabu Watanabe
Nobuyuki Ishibashi
Kouta Agematsu
Koichi Sughimoto
Tadashi Fujiwara
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Naito, Y.
Right arrow Articles by Fujiwara, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Naito, Y.
Right arrow Articles by Fujiwara, T.
Related Collections
Right arrow Congenital - cyanotic

Original Articles: Pediatric Cardiac

Factors Affecting Systemic Oxygen Delivery After Norwood Procedure With Sano Modification

Yuji Naito, MD*, Mitsuru Aoki, MD, Manabu Watanabe, MD, Nobuyuki Ishibashi, MD, Kouta Agematsu, MD, Koichi Sughimoto, MD, Tadashi Fujiwara, MD

Department of Cardiovascular Surgery, Chiba Children's Hospital, Chiba, Japan

Accepted for publication September 15, 2009.

* Address correspondence to Dr Naito, Department of Cardiovascular Surgery, Chiba Children's Hospital, 579-1, Heta-cho, Midori-ku, Chiba, 266-0007, Japan (Email: ujinaito{at}aol.com).

Presented at the Poster Session of the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

Background: The physiologic goal of management after a Norwood procedure is to optimize systemic oxygen delivery, as indicated by oxygen excess factor (OEF). Factors were examined that might affect systemic oxygen delivery after the Norwood procedure with right ventricle-to-pulmonary artery (RV-PA) conduit as the pulmonary blood supply.

Methods: Hemodynamic data of 9 patients (mean age, 25.0 days; mean weight, 2.9 kg) who underwent a modified Norwood operation for hypoplastic left heart syndrome (HLHS) between April 2003 and April 2008 were retrospectively analyzed. Variables were obtained by manometry and oximetry from indwelling catheters in the systemic artery, pulmonary artery, and superior vena cava at 3- to 6-hour intervals for 72 hours postoperatively. Systemic (Qs) and pulmonary (Qp) blood flow, systemic vascular resistance (SVR), and pulmonary vascular resistance (PVR) were calculated.

Results: A significant increase in SVR and decrease in PVR occurred during the first 6 hours, which might be inductive to sudden cardiovascular collapse. SVR and PVR significantly decreased over time through 24 hours, followed by a lower steady increase. OEF was closely correlated with SVR (p < 0.0001). No correlation of OEF with PVR (p = 0.65) was noted among the assumed variables. Mixed venous oxygen saturation (SVO 2) and OEF were strongly correlated. Pulmonary arterial pressure and OEF were weakly correlated.

Conclusions: Postoperative management strategies to maintain a low SVR, rather than manipulating PVR, appear to be rational to achieve adequate oxygen delivery after a Norwood procedure with Sano modification. The SVO 2 provides reliable prediction of OEF during postoperative hemodynamic recovery.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2010 by The Society of Thoracic Surgeons.