Division of Cardiothoracic Surgery, St Louis University School of Medicine and Cardinal Glennon Medical Center, St Louis, Mo.
Division of Pediatric Cardiology, St Louis University School of Medicine and Cardinal Glennon Medical Center, St Louis, Mo.
J Thorac Cardiovasc Surg. 2014 Jun;147(6):1777-82. doi: 10.1016/j.jtcvs.2014.02.066. Epub 2014 Feb 27.
Two different strategies have emerged in the initial palliation for hypoplastic left heart syndrome, the conventional Norwood operation and the so-called hybrid procedure. We have used each of these at our center. The purpose of the present study was to compare the outcomes of both procedures.
From 2007 to 2012, 40 patients presented to the Cardinal Glennon Children's Medical Center with hypoplastic left heart syndrome or 1 of its variants. Of the 40 patients, 24 underwent a hybrid procedure and 16 a Norwood procedure for initial palliation. The medical records, echocardiograms, and cardiac catheterization data were retrospectively reviewed. Standard statistical analysis was performed.
The patients who underwent the hybrid procedure weighed less than those who underwent the Norwood procedure. Overall unadjusted survival was better in the Norwood group, although this did not reach statistical significance. Overall hospital resource usage was similar in both cohorts, taking into account both first and second palliation stages.
In our review, we found no statistically significant difference in survival or resource usage between those patients undergoing the Norwood procedure and those undergoing a hybrid procedure as initial palliation for hypoplastic left heart syndrome.
在左心发育不全综合征的初始姑息治疗中出现了两种不同的策略，即传统的 Norwood 手术和所谓的杂交手术。我们在中心使用了这两种方法。本研究的目的是比较两种方法的结果。
2007 年至 2012 年，40 名患有左心发育不全综合征或其变体的患者在 Cardinal Glennon 儿童医院就诊。40 名患者中，24 例行杂交手术，16 例行 Norwood 手术进行初始姑息治疗。回顾性查阅病历、超声心动图和心导管检查数据。进行了标准的统计分析。
行杂交手术的患者体重小于行 Norwood 手术的患者。尽管这并未达到统计学意义，但 Norwood 组的总体未调整生存率更好。考虑到第一和第二姑息阶段，两组的整体医院资源使用情况相似。
在我们的回顾中，我们发现接受 Norwood 手术和杂交手术作为左心发育不全综合征初始姑息治疗的患者在生存率或资源使用方面没有统计学上的显著差异。
