Possibility of hybrid surgery for haemodynamic correction in a child with left heart hypoplasia syndrome: Clinical observation
Published 2020-07-03
Keywords
- clinical case,
- left heart hypoplasia syndrome newborn,
- Norwood operation,
- restenosis of the distal anastomosis
How to Cite
Copyright (c) 2020 Neverova Yu.N., Tarasov R.S., Khalivopulo I.K.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Owing to the development of prenatal diagnosis and interventional cardiology, newborns can survive complex palliative surgical procedures. Modern methods make it possible to change the principles of treatment for children undergoing haemodynamic correction, the last surgery being Fontan operation, and also stimulate the development of hybrid interventions (catheter procedures and surgical operations in the neonatal period). This article presents the dynamic monitoring of a child diagnosed with left heart hypoplasia syndrome, who underwent Norwood surgery at the age of 2 weeks, followed by restenosis of the distal anastomosis and balloon dilatation of neo-aorta restenosis with installation of a cobalt-chromium balloon-expandable stent (Andrastent XL) along with pararectal left-side access to the infrarenal section of the aorta at 11 months in order to reduce surgical risk and prepare for the next stage of correction (Glenn and Fontan operations).
Received 18 March 2020. Revised 10 April 2020. Accepted 17 April 2020.
Funding: The study did not have sponsorship.
Conflict of interest: Authors declare no conflict of interest.
References
- Sakurai T., Rogers V., Stickley J., Khan N., Jones T.J., Barron D.J., Brawn W.J. Single-center experience of arch reconstruction in the setting of Norwood operation. Ann Thorac Surg. 2012;94(5):1534-1539. PMID: 22841016. https://doi.org/10.1016/j.athoracsur.2012.05.097
- Whiteside W., Hirsch-Romano J., Yu S., Pasquali S.K., Armstrong A. Outcomes associated with balloon angioplasty for recurrent coarctation in neonatal univentricular and biventricular norwood-type aortic arch reconstructions. Catheter Cardiovasc Interv. 2014;83(7):1124-1130. PMID: 24323365. https://doi.org/10.1002/ccd.25318
- Sinha L., Ozturk M., Zurakowski D., Yerebakan C., Ramakrishnan K., Matisoff A., Ruth J., Jonas R.A., Sinha P. Intra-extracardiac versus extracardiac Fontan modifications: comparison of early outcomes. Ann Thorac Surg. 2019;107(2):560-566. PMID: 30273570. https://doi.org/10.1016/j.athoracsur.2018.07.080
- Тарасов Р.С., Нохрин А.В., Ануфриев А.И., Шушпанников П.А., Кузьмин И.В., Кузьмин А.В., Глебов К.К. Гибридная имплантация стента при рестенозе дистального анастомоза аорты после операции Норвуда (клиническое наблюдение). Диагностическая и интервенционная радиология. 2018;12(3);53-60. [Tarasov R.S., Nokhrin A.V., Anufriev A.I., Shushpannikov P.A., Kuzmin I.V., Kuzmin A.V., Glebov K.K. Hybrid stent implantation in restenosis of distal aortic anastomosis after Norwood surgery (clinical case). Diagnostic interventional radiology. 2018;12(3);53-60. (In Russ.)]
- Jonas R.A., Jacobs J.P., Jacobs M.L., Mavroudis C. Reporting of mortality associated with pediatric and congenital cardiac surgery. J Thorac Cardiovasc Surg. 2010;140(3):726;author reply 726-727. PMID: 20723742. https://doi.org/10.1016/j.jtcvs.2010.04.034
- Vitanova K., Cleuziou J., Pabst von Ohain J., Burri M., Eicken A., Lange R. Recoarctation after Norwood I procedure for hypoplastic left heart syndrome: impact of patch material. Ann Thorac Surg. 2017;103(2):617-621. PMID: 28024650. https://doi.org/10.1016/j.athoracsur.2016.10.030
- Нохрин А.В., Ануфриев А.И., Бедин А.В., Халивопуло И.К. Первый опыт хирургического лечения инфантильной коарктации в сочетании с гипоплазией дуги аорты. Комплексные проблемы сердечно-сосудистых заболеваний. 2013;4:35-41. [Nokhrin A.V., Anufriev A.I., Bedin A.V., Halivopulo I.K. First experience of surgical treatment of neonatal coarctation with aortic arch hypoplasia. Complex Issues of Cardiovascular Diseases. 2013;4:35-41. (In Russ.)] https://doi.org/10.17802/2306-1278-2013-4-35-41
- Eagam M., Loomba R.S., Pelech A.N., Tweddell J.S., Kirkpatrick E. Predicting the need for neoaortic arch intervention in infants with hypoplastic left heart syndrome through the Glenn procedure. Pediatr. Cardiol. 2017;38(1):70-76. PMID: 27803958. https://doi.org/10.1007/s00246-016-1485-5
- Bentham J.R., Thomson J.D.R. Current state of interventional cardiology in congenital heart disease. Arch Dis Child. 2015;100(8):787-792. PMID: 25678596. https://doi.org/10.1136/archdischild-2014-306052
- Porras D., Brown D.W., Marshall A.C., Del Nido P., Bacha E.A., McElhinney D.B. Factors associated with subsequent arch reintervention after initial balloon aortoplasty in patients with Norwood procedure and arch obstruction. J Am Coll Cardiol. 2011;58(8):868-876. PMID: 21835324, PMCID: PMC3407888. https://doi.org/10.1016/j.jacc.2010.12.050
- Januszewska K., Kozlik-Feldmann R., Kordon Z., Urschel S., Netz H., Reichart B., Malec E. Significance of the residual aortic obstruction in multistage repair of hypoplastic left heart syndrome. Eur J Cardiothorac Surg. 2011;40(2):508-513 PMID: 21295990. https://doi.org/10.1016/j.ejcts.2010.12.023
- Пурсанов М.Г., Беришвили Д.О., Соболев А.В., Нефедова И.Е., Лязин Д.В., Калашников С.В., Степаничева О.А., Бавеян А.О. Первый случай одномоментного гибридного стентирования обструкции дуги аорты и стенозированной левой легочной артерии у пациента после операции Норвуда I. Детские болезни сердца и сосудов. 2018;15(3):175-81. [Pursanov M.G., Berishvili D.O., Sobolev A.V., Nefedova I.E., Lyazin D.V., Kalashnikov S.V., Stepanicheva O.A., Baveyan A.O. First case of simultaneous hybrid stenting of obstructed aortic arch and left pulmonary artery stenosis in patient after Norwood I. Children's heart and vascular diseases. 2018;15(3):175-81. (In Russ.)] https://doi.org/10.24022/1810-0686-2018-15-3-175-181
