https://scholars.lib.ntu.edu.tw/handle/123456789/434114
標題: | Evolving strategies and improving outcomes of Norwood stage one reconstruction: A decade experience of a single institution in Taiwan | 作者: | EN-TING WU SHU-CHIEN HUANG YIH-SHARNG CHEN CHUNG-I CHANG JOU-KOU WANG MEI-HWAN WU ING-SH CHIU |
公開日期: | 2008 | 卷: | 56 | 期: | 6 | 起(迄)頁: | 348-352 | 來源出版物: | Thoracic and Cardiovascular Surgeon | 摘要: | Aim: The aim of this study was to define the improvement in short-term outcome and risk factors of Norwood stage one reconstruction for hypoplastic left heart syndrome (HLHS) in Taiwan, after implementing new perioperative management strategies. Methods: Data were retrieved from a retrospective chart review of patients with HLHS treated between July 1997 and July 2007. Since we implemented new perioperative strategies in 2004, we divided our patients into two groups, early era (1997-2003) and late era (2004-2007), and compared the outcome. Results: We enrolled 48 patients. In the early era group (n=28), the diagnosis was confirmed by cardiac catheterization and controlled ventilation was used to manipulate the balance between systemic and pulmonary blood flow. The survival rate was only 17.9% (5/28). Surgery was performed at 15.2±10.7 days, which was significantly later than in the late era group (4.6 ± 4.0 days, n=20). A lower preoperative shock and more prenatal diagnoses were recorded for the late era group. RV-PA conduit was used in 17 patients in the late era group of which 12 (70.6%) survived to be discharged from hospital. The risk factor was significant TR (triscupid regurgitation). Conclusions: With our contemporary perioperative management and change in surgical strategy, survival after first-stage palliation has improved. We believe that our HLHS experience is valuable for low volume centers and also for Asian co-horts. ? Georg Thieme Verlag KG Stuttgart. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-53349121300&doi=10.1055%2fs-2008-1038636&partnerID=40&md5=7fcdb2a8c82b1c1a1c288e740348f926 https://scholars.lib.ntu.edu.tw/handle/123456789/434114 |
ISSN: | 0171-6425 | DOI: | 10.1055/s-2008-1038636 | SDG/關鍵字: | adolescent; adult; article; artificial ventilation; brain decompression; brain hemorrhage; child; chylothorax; controlled study; female; graft occlusion; heart catheterization; hospital discharge; human; hypoplastic left heart syndrome; infant; information retrieval; lung blood flow; major clinical study; male; mediastinitis; medical record review; Norwood procedure; palliative therapy; perioperative period; prenatal diagnosis; preoperative period; priority journal; retrospective study; right ventricle to pulmonary artery conduit; risk factor; sepsis; surgical mortality; surgical risk; surgical technique; survival rate; systemic circulation; Taiwan; treatment outcome; tricuspid valve regurgitation; vocal cord paralysis; Cardiac Surgical Procedures; Female; Humans; Hypoplastic Left Heart Syndrome; Infant; Infant, Newborn; Kaplan-Meiers Estimate; Male; Palliative Care; Quality of Health Care; Retrospective Studies; Risk Assessment; Risk Factors; Taiwan; Time Factors; Treatment Outcome |
顯示於: | 醫學系 |
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