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Heart, Lung and Circulation

Outcomes After Stage I Norwood Palliation in a Recently Established Program Can Achieve Results Similar to Longer Established Services

  • Sebastian Rimpau
    Affiliations
    Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, Qld, Australia

    University of Queensland, School of Clinical Medicine, Brisbane, Qld, Australia
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  • Kristen Gibbons
    Affiliations
    Paediatric Critical Care Research Group (PCCRG), The University of Queensland, Brisbane, Qld, Australia
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  • Prem Venugopal
    Affiliations
    Paediatric Critical Care Research Group (PCCRG), The University of Queensland, Brisbane, Qld, Australia

    Department of Paediatric Cardiothoracic Surgery, Queensland Children's Hospital, Brisbane, Qld, Australia

    Queensland Paediatric Cardiac Service (QPCS), Queensland Children's Hospital, Brisbane, Qld, Australia
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  • Nelson Alphonso
    Affiliations
    Paediatric Critical Care Research Group (PCCRG), The University of Queensland, Brisbane, Qld, Australia

    Department of Paediatric Cardiothoracic Surgery, Queensland Children's Hospital, Brisbane, Qld, Australia

    Queensland Paediatric Cardiac Service (QPCS), Queensland Children's Hospital, Brisbane, Qld, Australia
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  • Benjamin Anderson
    Affiliations
    University of Queensland, School of Clinical Medicine, Brisbane, Qld, Australia

    Paediatric Critical Care Research Group (PCCRG), The University of Queensland, Brisbane, Qld, Australia

    Queensland Paediatric Cardiac Service (QPCS), Queensland Children's Hospital, Brisbane, Qld, Australia
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  • Kerry E. Johnson
    Affiliations
    Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, Qld, Australia

    Paediatric Critical Care Research Group (PCCRG), The University of Queensland, Brisbane, Qld, Australia
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  • Adrian C. Mattke
    Correspondence
    Corresponding author at: Queensland Children’s Hospital, Paediatric Intensive Care Unit, 501 Stanley St, South Brisbane, QLD 4101
    Affiliations
    Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, Qld, Australia

    University of Queensland, School of Clinical Medicine, Brisbane, Qld, Australia

    Paediatric Critical Care Research Group (PCCRG), The University of Queensland, Brisbane, Qld, Australia
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Published:April 06, 2022DOI:https://doi.org/10.1016/j.hlc.2022.02.004

      Background

      Infants with hypoplastic left heart syndrome (HLHS) or similar single ventricle cardiac lesions require a three-stage surgical approach, the first step being the Stage I Norwood procedure. The Queensland Children’s Hospital (QCH) in Australia is a tertiary hospital providing the only cardiac surgical service to children in Queensland and northern New South Wales.

      Objective

      To review the centre’s outcomes of Norwood procedures performed in the last 6 years.

      Materials and Methods

      We retrospectively evaluated all infants undergoing the stage I Norwood procedure between January 2015 and August 2021. Mortality, intensive care length of stay, events of cardiac arrest following surgery and duration of mechanical ventilation were calculated and analysed for subgroups depending on type of pulmonary shunt type (right-ventricle-to-pulmonary-artery shunt [RVPAS] vs the modified Blalock-Taussig shunt [MBTS]).

      Results

      Forty-nine (49) patients were included. Overall survival to stage two operation (Glenn) was 90%. Both shunts were used evenly with the RVPA conduit preferred for HLHS and the MBTS largely chosen for hypoplastic left heart variants. In univariable analysis there was no difference in cardiac arrest or mortality rate for the patient with a RVPAS compared to the patient with a MBTS.

      Conclusion

      We show that a recently established Norwood program can achieve results that are comparable to those reported by longer established centres, and the international literature.

      Keywords

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