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

引用

World Journal of Clinical Pediatrics 2016年第3期5卷 319-324页

作者： Kurt D Piggott Grace George Harun Fakioglu Carlos Blanco Sukumar Saguna Narasimhulu kamal pourmoghadam Hamish Munroe William Decampli the Heart Center at Arnold Palmer Hospital for Children Pediatric Cardiac Intensive Care Medicine

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

关键词： Congenital heart disease Heterotaxy Single-ventricle Pediatrics Ladd’s procedure Congenital heart disease

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