Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Vventricle Reconstruction trial.
PMCID: PMC3544195 DOI: 10.1161/CIRCULATIONAHA.111.072694
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.
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
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).
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