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Ann Thorac Surg 2006;82:1168-1169
© 2006 The Society of Thoracic Surgeons

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Correspondence

Stenting of a Stenosed Sano Shunt After Palliation in Hypoplastic Left Heart Syndrome

Department of Paediatric Cardiology and Congenital Heart Disease, Clinic of Cardiovascular Surgery, German Heart Center Munich at the Technical University Munich, Lazarettstr 36, Munich, 80636 Germany

(Email: eicken{at}dhm.mhn.de).

To the Editor:

We read with interest the contribution of Nigro and colleagues [1] on sudden death due to proximal conduit obstruction after a Sano modified Norwood procedure. We completely agree with the authors that vigilance in this complex setting is crucial and have adopted a policy of early routine cardiac catheterization (< 4 months after the initial operation) and subsequent second stage palliation in patients with hypoplastic left heart syndrome. If however conduit obstruction occurs at an early postoperative stage (< 1 month) and partial cavopulmonary connection does not seem feasible, we suggest stenting of the stenosed Sano shunt [2]. So far we performed successful stent implantation for this indication in three infants (Fig 1). Our procedure helped to avoid repeat surgical shunt procedure. Hence potential negative effects on myocardial function, which was a key issue and concern in these patients [3], were prevented.

View larger version (45K): [in this window] [in a new window]   Fig. 1. (A) Stenosed Sano shunt. (B) Stent (EV3 Primus GPS, 5 x 12 mm; EV3 Inc, Plymouth, MN) expansion. (C) Post intervention.

	References

Top References

 

1. Nigro JJ, Bart RD, Derby CD, Sklansky MS, Starnes VA. Proximal conduit obstruction after Sano modified Norwood procedure Ann Thorac Surg 2005;80:1924-1928.[Abstract/Free Full Text]
2. Eicken A, Sebening W, Genz Th, Schreiber C, Hess J. Stenting of a stenosed Sano shunt in a neonate with hypoplastic left heart syndrome Pediatr Cardiol 2005;26:877-878.[Medline]
3. Eicken A, Fratz S, Gutfried C, et al. Hearts late after Fontan operation have normal mass, normal volume, and reduced systolic functiona magnetic resonance imaging study. J Am Coll Cardiol 2003;42:1061-1065.[Abstract/Free Full Text]

This article has been cited by other articles:

				J. J. Nigro and J. Graziano Reply. Ann. Thorac. Surg., September 1, 2006; 82(3): 1169 - 1169. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Christian Schreiber Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Eicken, A. Articles by Schreiber, C. Search for Related Content PubMed PubMed Citation Articles by Eicken, A. Articles by Schreiber, C. Related Collections Congenital - cyanotic Related Article