Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Vventricle Reconstruction trial.

Creator(s)

Peter C. Frommelt
Lin T. Guey
L LuAnn Minich
Majeed Bhat
Tim J. Bradley
Steve D. Colan
Greg Ensing
Jessica Gorentz
Haleh Heydarian
J Blaine John
Wyman W. Lai
Jami C. Levine
William T. Mahle
Stephen G. Miller
Richard G. Ohye
Gail D. Pearson
Girish S. Shirali, Children's Mercy HospitalFollow
Pierre C. Wong
Meryl S. Cohen
Pediatric Heart Network Investigators

Document Type

Article

Publication Date

5-29-2012

Identifier

PMCID: PMC3544195 DOI: 10.1161/CIRCULATIONAHA.111.072694

Abstract

BACKGROUND: The Pediatric Heart Network trial comparing outcomes in 549 infants with single right ventricle undergoing a Norwood procedure randomized to modified Blalock-Taussig shunt or right ventricle-pulmonary artery shunt (RVPAS) found better 1-year transplant-free survival in those who received RVPAS. We sought to compare the impact of shunt type on echocardiographic indices of cardiac size and function up to 14 months of age.

METHODS AND RESULTS: A core laboratory measured indices of cardiac size and function from protocol exams: early after Norwood procedure (age 22.5 ± 13.4 days), before stage II procedure (age 4.8 ± 1.8 months), and at 14 months (age 14.3 ± 1.2 months). Mean right ventricular ejection fraction was

CONCLUSIONS: Indices of cardiac size and function after the Norwood procedure are similar for modified Blalock-Taussig shunt and RVPAS by 14 months of age. Interstage differences between shunt types can likely be explained by the physiology created when the shunts are in place rather than by intrinsic differences in cardiac function.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00115934.

Journal Title

Circulation

Volume

125

Issue

21

First Page

2630

Last Page

2638

MeSH Keywords

Anastomosis, Surgical; Blalock-Taussig Procedure; Diastole; Echocardiography; Heart Ventricles; Humans; Hypoplastic Left Heart Syndrome; Infant; Infant, Newborn; Myocardium; Norwood Procedures; Organ Size; Pulmonary Artery; Stroke Volume; Systole; Treatment Outcome

Comments

Secondary source ID

• ClinicalTrials.gov/NCT00115934

Grant support

• U01 HL068269/HL/NHLBI NIH HHS/United States

• U01 HL068279/HL/NHLBI NIH HHS/United States

• U01 HL068290/HL/NHLBI NIH HHS/United States

• U01 HL068288/HL/NHLBI NIH HHS/United States

• U10 HL068270/HL/NHLBI NIH HHS/United States

• U01 HL068281/HL/NHLBI NIH HHS/United States

• U01 HL068270/HL/NHLBI NIH HHS/United States

• U01 HL068292/HL/NHLBI NIH HHS/United States

• U01 HL085057/HL/NHLBI NIH HHS/United States

• U01 HL068285/HL/NHLBI NIH HHS/United States

Recommended Citation

Frommelt, P. C., Guey, L. T., Minich, L. L., Bhat, M., Bradley, T. J., Colan, S. D., Ensing, G., Gorentz, J., Heydarian, H., John, J. B., Lai, W. W., Levine, J. C., Mahle, W. T., Miller, S. G., Ohye, R. G., Pearson, G. D., Shirali, G. S., Wong, P. C., Cohen, M. S., . Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Vventricle Reconstruction trial. Circulation 125, 2630-2638 (2012).