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Isolated left ventricular ischemia after the Norwood procedure
Joseph J DeRose1, Rozelle Corda, M Renate Dische
1Department of Pathology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
The Annals of Thoracic Surgery
|February 16, 2002
Summary
Aortic atresia, a severe form of hypoplastic left heart syndrome (HLHS), presents risks post- Norwood procedure. This case highlights isolated left ventricular ischemia due to coronary artery anomalies in a neonate.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Aortic atresia is the most severe hypoplastic left heart syndrome (HLHS) variant.
- Significant mortality is associated with stage I palliation in these patients.
- Coronary artery abnormalities are more common, particularly with a patent mitral valve.
Observation:
- A neonate with HLHS, left ventricular hypertrophy, mitral stenosis, aortic atresia, and anomalous left coronary artery underwent the Norwood procedure.
- The patient developed isolated left ventricular ischemia post-operatively.
Findings:
- This case details isolated left ventricular ischemia in a neonate with complex congenital heart disease.
- An anomalous left coronary artery was identified as a contributing factor.
Implications:
- Understanding coronary artery anomalies is crucial for managing aortic atresia and HLHS.
- This case underscores the importance of vigilant post-operative monitoring for ischemia in high-risk neonates.
- Further research into surgical strategies for complex coronary anomalies in HLHS is warranted.