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首页> 外文期刊>Pediatric Cardiology >A Decade of Staged Norwood Palliation in Hypoplastic Left Heart Syndrome in a Midsized Cardiosurgical Center
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A Decade of Staged Norwood Palliation in Hypoplastic Left Heart Syndrome in a Midsized Cardiosurgical Center

机译：在中型心脏外科中心发育不良的左心综合征中分期进行的Norwood姑息治疗十年

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摘要

Hypoplastic left heart syndrome (HLHS) is a challenge for the pediatric cardiologist and the surgeon. It is generally assumed that the postoperative outcome after surgery for congenital heart disease is influenced by the institutional size. We present the results of 43 patients with true HLHS (situs solitus and atrioventricular and ventriculoarterial concordance) referred for operation between 1992 and 2002 in our center. Two children had atrioseptostomy: one died soon after the operation, and the other one was transplanted successfully but died at the age of 6 months following acute rejection. The remaining 41 underwent Norwood I palliation, 21 stage II palliation, and 10 stage III palliation. Early mortality was 29% after stage I operation, 4.7% after stage II palliation, and 0% after stage III operation. Overall mortality was 39% after stage I, 9.5% after stage II, and 10% after stage III operation. Low birth weight was associated with a higher mortality (p < 0.05). Mortality declined with increasing experience, comparable to the results of very large cardiosurgical centers with many more patients. The quality of surgery and perioperative management in smaller pediatric cardiosurgical centers can reach the level of very large centers.
机译：左心发育不全综合征（HLHS）对于小儿心脏病专家和外科医生都是一个挑战。通常认为，先天性心脏病的手术后结局受机构规模的影响。我们提供了1992年至2002年间在我中心接受转诊的43例真正的HLHS（单阴，房室和心室动脉的一致性）患者的结果。两名儿童进行了房室造口术：一名在手术后不久死亡，另一名成功移植，但在急性排斥反应后6个月时死亡。其余41例分别接受Norwood I缓解，21阶段II缓解和10阶段III缓解。 I期手术后的早期死亡率为29％，II期手术后为4.7％，III期手术后为0％。 I期后总死亡率为39％，II期后为9.5％，III期手术后为10％。低出生体重与较高的死亡率相关（p <0.05）。随着经验的增加，死亡率下降了，这与拥有更多病人的大型心脏外科中心的结果相当。较小的小儿心脏外科手术中心的手术质量和围手术期管理可以达到非常大的中心水平。

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  • 来源
    《Pediatric Cardiology》 |2005年第6期|751-755|共5页
  • 作者

    T. Krasemann; H. Fenge; H.-G. Kehl; A. Rukosujew; C. Schmid; H.-H. Scheld; T.D.T. Tjan; J. Vogt;

  • 作者单位

    Department of Pediatric Cardiology University Childrens Hospital Muenster;

    Department of Pediatric Cardiology University Childrens Hospital Muenster;

    Department of Pediatric Cardiology University Childrens Hospital Muenster;

    Department of Thoracic and Cardiovascular Surgery University Hospital Muenster;

    Department of Thoracic and Cardiovascular Surgery University Hospital Muenster;

    Department of Thoracic and Cardiovascular Surgery University Hospital Muenster;

    Department of Thoracic and Cardiovascular Surgery University Hospital Muenster;

    Department of Pediatric Cardiology University Childrens Hospital Muenster;

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  • 正文语种 eng
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  • 关键词

    Hypoplastic left heart syndrome; Mortality rate; Hospital size;

    机译：发育不良的左心综合征;死亡率;医院规模;

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