CIRUGIA DE NORWOOD PDF

  • June 18, 2019

▫La cirugía busca minimizar los factores de riesgo que acechan al Norwood estadio I Fontan atriopulmonar: Conexión de AD con TP para q sangre de. The Fontan procedure or Fontan–Kreutzer procedure is a palliative surgical procedure used in from their existing blood supply (e.g. a shunt created during a Norwood procedure, a patent ductus arteriosus, etc.). Leval, Marc R de ( ). d Servicio de Cirugía Cardiovascular, Hospital Infantil Universitario Virgen del Between October and June , 42 children underwent the Norwood.

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Jack Rychik, head of the Single Ventricle Survivorship Program at Children’s Hospital of Philadelphia summarized the long-term consequences of Fontan circulation as an “indolent and progressive state of heart failure” with predictable long term consequences on several organ systems.

It involves diverting the venous blood from the inferior vena cava IVC and superior vena cava SVC to the pulmonary arteries without passing through the morphologic right ventricle ; i. With the same objective, postsurgical hemodynamic and respiratory variables were analyzed Table 1gathered by means of a standardized protocol and included in a database.

In the analytical control we measured arterial and venous blood gases, oxygen saturation SO 2 by noninvasive, and continuous pulse-oxymetry and the carbon dioxide CO 2 through capnography. In a review, Dr. The Fontan procedure or Fontan—Kreutzer procedure is a palliative surgical procedure used in children with univentricular hearts. Previous Article Vol The surgical technique used in them to reconstruct the aortic arc was the terminoterminal suture without aortic graft.

It was initially described in by Dr.

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Articles needing additional references from February All articles needing additional references. In relation to the surgical times, only the time of ECC was associated significantly with mortality, so that it was greater in those that died in the operating room Table 6 and in PICU Table norwkod.

Fontan procedure

Cardiac arrest with profound hypothermia was used in all and regional cerebral nowrood was used in nine. This fact is related in part with the introduction of a modification in the classical Norwood technique, consisting in the substitution of the fistula for a tube connecting the right ventricle with the pulmonary artery.

The single ventricle is doing nearly twice the expected amount of work because it has to pump blood for the body and lungs. Thirteen patients 9 females, age range days and median weight of 3. That is, the pulmonary arteries are disconnected from their existing blood supply e. As far as the postsurgical monitorization in the PICU, there were no significant differences between the groups of survivors and deceased in the following variables: February Learn how and when to remove this template message.

Between October and June42 children underwent the Norwood procedure. Its evaluation makes us indirectly estimate the adequacy of the systemic flow. We used pressure support ventilatory modalities to facilitate spontaneous breathing and digestive tolerance. Fontan procedure is also contraindicated in those with pulmonary artery hypoplasia, patients with left ventricular dysfunction and significant mitral insufficiency.

This is also norwooc reason a Fontan procedure cannot be done immediately after birth; the pulmonary vascular resistance is high in utero and takes months to drop. Primary sternum closure was also a risk factor in the sense that the children that underwent such a procedure in the operating room had a higher mortality, both intrasurgically Table 6 as postsurgically in the PICU Table 3. Received November 17, By using this site, you agree to the Terms of Use and Privacy Policy.

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We have not demonstrated an increase in survival of children in the PICU who underwent surgery using the Sano-modified of the classic Norwood technique. The age and the weight of the children at the moment of the intervention did not virugia a significant statistical relationship with mortality Table 3. In other projects Wikimedia Commons. Images subject to Copyright.

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Two of the patients who did not undergo the homograft had respiratory insufficiency after being weaned from mechanical ventilation, with an extrinsic compression of the pulmonary artery and left main bronchus cirkgia the neoaorta, demonstrated through an airway study.

Progress in Pediatric Cardiology.

Fontan procedure – Wikipedia

When the pressure in the veins is high, some of the oxygen-poor blood can escape through the fenestration to relieve the pressure. In the short term, children can have trouble with pleural effusions fluid building up around the lungs. Screening protocols and treatment standards are emerging in the light of these discoveries.