Single institution experience with the Ladd's procedure in patients with heterotaxy and stage Ⅰ palliated single-ventricle

作     者：Kurt D Piggott Grace George Harun Fakioglu Carlos Blanco Sukumar Saguna Narasimhulu Kamal Pourmoghadam Hamish Munroe William Decampli 

作者机构：the Heart Center at Arnold Palmer Hospital for ChildrenPediatric Cardiac Intensive Care Medicine 

出 版 物：《World Journal of Clinical Pediatrics》 (世界临床儿科杂志)

年 卷 期：2016年第5卷第3期

页      面：319-324页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：Congenital heart disease Heterotaxy Single-ventricle Pediatrics Ladd’s procedure Congenital heart disease 

摘      要：AIM:To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd s ***:We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation.A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd s procedure during this time *** reviewed each patients chart to determine if significant intraoperative or post-operative morbidity or mortality *** also described our protocolized management of these patients in the cardiac intensive care unit,which included pre-operative labs,echocardiography,milrinone infusion,as well as protocolized fluid administration and anticoagulation *** also reviewed the literature to determine the reported morbidity and mortality associated with the Ladd s procedure in this particular cardiac physiology and if other institutions have reported protocolized care of these ***:A total of 8 patients were identified to have heterotaxy with an intestinal rotation anomaly and single-ventricle heart disease that was status post single ventricle *** of these patients were palliated with a Blaylock-Taussig shunt,one of whom underwent a Norwood *** two other patients were palliated with a stent,which was placed in the ductus *** eight patients all underwent elective Ladd s procedure at the time of gastrostomy tube *** our protocol,all patients remained on aspirin prior to surgery and had no period where they were without *** patients remained on milrinone during and after the procedure and received fluid administration upon arrival to the cardiac intensive care unit to account for *** 8 patients experienced no intraoperative or post-o