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Soynov I.A.

Meshalkin National Medical Research Center

Gorbatykh A.V.

National Medical Research Center

Kulyabin Yu.Yu.

National Medical Research Center

Arkhipov A.N.

National Medical Research Center

Nichai N.R.

Meshalkin National Medical Research Center

Zubritskiy A.V.

National Medical Research Center

Voitov A.V.

Meshalkin National Medical Research Center

Gorbatykh Yu.N.

National Medical Research Center

Galstyan M.G.

Meshalkin National Medical Research Center

Bogachev-Prokofiev A.V.

Meshalkin National Medical Research Center

Early and long-term results after the Norwood procedure

Authors:

Soynov I.A., Gorbatykh A.V., Kulyabin Yu.Yu., Arkhipov A.N., Nichai N.R., Zubritskiy A.V., Voitov A.V., Gorbatykh Yu.N., Galstyan M.G., Bogachev-Prokofiev A.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(5): 59‑67

DOI: 10.17116/hirurgia202205159

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Table of contents

EARLY AND LONG-TERM RESULTS AFTER THE NORWOOD PROCEDURE
EARLY AND LONG-TERM RESULTS AFTER THE NORWOOD PROCEDURE

To cite this article:

Soynov IA, Gorbatykh AV, Kulyabin YuYu, et al. . Early and long-term results after the Norwood procedure. Pirogov Russian Journal of Surgery. 2022;(5):59‑67. (In Russ.)
https://doi.org/10.17116/hirurgia202205159

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
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OBJECTIVE

To assess the early and long-term results after the Norwood procedure and to identify predictors of aortic recoarctation and arterial hypertension.

MATERIAL AND METHODS

We have operated on 2789 infants in the department of congenital heart diseases of the Meshalkin National Medical Research Center between January 2015 and December 2018. The current single-center prospective cohort study included 39 (1.4%) patients with hypoplastic left heart syndrome who underwent the Norwood procedure.

RESULTS

In-hospital mortality was 15.3% (n=6). An inter-stage mortality was 10.2% (n=4). Recoarctation of the aorta and Sano shunt stenosis in inter-stage period occurred in 8 (24.2%) and 4 patients (12.1%), respectively. Body mass <3 kg was the only risk factor of recoarctation (OR 7.08, 95% CI 1.17; 42.79, p=0.033). We found no risk factors of Sano shunt stenosis. There were no signs of recoarctation and Sano shunt dysfunction in the early postoperative period. Arterial hypertension developed in 14 (48.3%) patients. We found the correlation between systolic blood pressure and ventricular ejection fraction (β coefficient –0.88, 95% CI –1.33; –0.44, p=0.001). The only risk factor of arterial hypertension was increased stiffness of the aorta.

CONCLUSION

The early and inter-stage mortality are still the issues after the Norwood procedure. Postoperative reduced ejection fraction of single ventricle is one of the most common complications that could be related with residual arterial hypertension.

Keywords:

hypoplastic left heart syndrome
Norwood procedure
inter-stage period
recoarctation
arterial hypertension

Authors:

Soynov I.A.

Meshalkin National Medical Research Center

Gorbatykh A.V.

National Medical Research Center

Kulyabin Yu.Yu.

National Medical Research Center

Arkhipov A.N.

National Medical Research Center

Nichai N.R.

Meshalkin National Medical Research Center

Zubritskiy A.V.

National Medical Research Center

Voitov A.V.

Meshalkin National Medical Research Center

Gorbatykh Yu.N.

National Medical Research Center

Galstyan M.G.

Meshalkin National Medical Research Center

Bogachev-Prokofiev A.V.

Meshalkin National Medical Research Center

Received:

02.09.2021

Accepted:

01.10.2021

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