A operação de Norwood modificada para tratamento da síndrome de hipoplasia do coração esquerdo Modified Norwood procedure for hypoplastic left heart syndrome

AbstractObjetive : To show current results of a modified Norwoodprocedure, where only autologous tissues are used in thereconstruction of the new aortic arch. Method : Between January and December of 2002, fiveneonates with hypoplastic left heart syndrome underwentthe modified Norwood operation. Their ages ranged fromtwo to nine days and their weight from 2.5 to 3.7 kg. Themean diameter of the ascending aorta was 6.2 mm. Thesurgical technique described by FRASER and MEE wasemployed using exclusively autologous tissue to achieve aorticarch reconstruction. Results : The systemic-pulmonary shunt was perfomed witha 3.0 mm PTFE graft in three patients and with 3.5 mm graftin the other two. Deep hypothermic and circulatory arrestwere used in all patients with CP bypass time ranging from128 to 212 minutes (mean: 154) and circulatory arrest from41-60 min (mean: 52). There were no intraoperative deathsand all patients underwent delayed sternal closure. Therewas one postoperative death (9 th day) caused by sepsis. Therewas one death two months after discharge cause by aspirationand pneumonia. One child underwent a 2-direcional Glennand the other two are still waiting for the second stage.