Preoperative management for tricuspid regurgitation in hypoplastic left heart syndrome

Kenji Baba, Shin-ichi Ohtsuki, Masahiro Kamada, Kouichi Kataoka, Naoki Ohno, Yoshio Okamoto, Mamoru Takeuchi, Tatsuo Iwasaki, Shunji Sano, Tsuneo Morishima

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Tricuspid regurgitation (TR) is an important finding in hypoplastic left heart syndrome (HLHS). The aim of the present study was to investigate changes in the degree of TR after the preoperative management of HLHS with mechanical ventilation, and whether the improvement of TR under preoperative management would affect the short-term prognosis of Norwood operation. Methods: Clinical and echocardiographic data of 55 patients with HLHS who underwent preoperative echocardiography and management at Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, were retrospectively reviewed. Preoperative management with mechanical ventilation was performed in 31 of these patients. Based on echocardiography the 55 patients were divided into a trivial-mild TR group (group A) and a moderate-severe TR group (group B). Results: After preoperative management, TR improved in six of the 31 patients and was unchanged in 25; in five of the nine group B patients, TR before management improved to the level of group A after management. In-hospital deaths after surgery included 17 of the 48 patients in group A and five of the six in group B, but there was only one death in the five patients for whom TR improved from group B to group A level. Conclusion Preoperative management of HLHS resulted in an improvement in the degree of TR. The short-term prognosis was better for the patients in group A than those in group B, and so preoperative management is useful for HLHS patients, especially those with moderate or severe TR at admission, with the exception of severe dysplasia of tricuspid valve.

Original languageEnglish
Pages (from-to)399-404
Number of pages6
JournalPediatrics International
Volume51
Issue number3
DOIs
Publication statusPublished - Jun 2009

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Hypoplastic Left Heart Syndrome
Tricuspid Valve Insufficiency
Artificial Respiration
Echocardiography
Norwood Procedures
School Dentistry
Tricuspid Valve
Medicine
Pediatrics

Keywords

  • Congenital heart disease
  • Echocardiography
  • Hypoplastic left heart syndrome
  • Preoperative management
  • Tricuspid regurgitation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Preoperative management for tricuspid regurgitation in hypoplastic left heart syndrome. / Baba, Kenji; Ohtsuki, Shin-ichi; Kamada, Masahiro; Kataoka, Kouichi; Ohno, Naoki; Okamoto, Yoshio; Takeuchi, Mamoru; Iwasaki, Tatsuo; Sano, Shunji; Morishima, Tsuneo.

In: Pediatrics International, Vol. 51, No. 3, 06.2009, p. 399-404.

Research output: Contribution to journalArticle

Baba, Kenji ; Ohtsuki, Shin-ichi ; Kamada, Masahiro ; Kataoka, Kouichi ; Ohno, Naoki ; Okamoto, Yoshio ; Takeuchi, Mamoru ; Iwasaki, Tatsuo ; Sano, Shunji ; Morishima, Tsuneo. / Preoperative management for tricuspid regurgitation in hypoplastic left heart syndrome. In: Pediatrics International. 2009 ; Vol. 51, No. 3. pp. 399-404.
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abstract = "Background: Tricuspid regurgitation (TR) is an important finding in hypoplastic left heart syndrome (HLHS). The aim of the present study was to investigate changes in the degree of TR after the preoperative management of HLHS with mechanical ventilation, and whether the improvement of TR under preoperative management would affect the short-term prognosis of Norwood operation. Methods: Clinical and echocardiographic data of 55 patients with HLHS who underwent preoperative echocardiography and management at Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, were retrospectively reviewed. Preoperative management with mechanical ventilation was performed in 31 of these patients. Based on echocardiography the 55 patients were divided into a trivial-mild TR group (group A) and a moderate-severe TR group (group B). Results: After preoperative management, TR improved in six of the 31 patients and was unchanged in 25; in five of the nine group B patients, TR before management improved to the level of group A after management. In-hospital deaths after surgery included 17 of the 48 patients in group A and five of the six in group B, but there was only one death in the five patients for whom TR improved from group B to group A level. Conclusion Preoperative management of HLHS resulted in an improvement in the degree of TR. The short-term prognosis was better for the patients in group A than those in group B, and so preoperative management is useful for HLHS patients, especially those with moderate or severe TR at admission, with the exception of severe dysplasia of tricuspid valve.",
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author = "Kenji Baba and Shin-ichi Ohtsuki and Masahiro Kamada and Kouichi Kataoka and Naoki Ohno and Yoshio Okamoto and Mamoru Takeuchi and Tatsuo Iwasaki and Shunji Sano and Tsuneo Morishima",
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AU - Baba, Kenji

AU - Ohtsuki, Shin-ichi

AU - Kamada, Masahiro

AU - Kataoka, Kouichi

AU - Ohno, Naoki

AU - Okamoto, Yoshio

AU - Takeuchi, Mamoru

AU - Iwasaki, Tatsuo

AU - Sano, Shunji

AU - Morishima, Tsuneo

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N2 - Background: Tricuspid regurgitation (TR) is an important finding in hypoplastic left heart syndrome (HLHS). The aim of the present study was to investigate changes in the degree of TR after the preoperative management of HLHS with mechanical ventilation, and whether the improvement of TR under preoperative management would affect the short-term prognosis of Norwood operation. Methods: Clinical and echocardiographic data of 55 patients with HLHS who underwent preoperative echocardiography and management at Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, were retrospectively reviewed. Preoperative management with mechanical ventilation was performed in 31 of these patients. Based on echocardiography the 55 patients were divided into a trivial-mild TR group (group A) and a moderate-severe TR group (group B). Results: After preoperative management, TR improved in six of the 31 patients and was unchanged in 25; in five of the nine group B patients, TR before management improved to the level of group A after management. In-hospital deaths after surgery included 17 of the 48 patients in group A and five of the six in group B, but there was only one death in the five patients for whom TR improved from group B to group A level. Conclusion Preoperative management of HLHS resulted in an improvement in the degree of TR. The short-term prognosis was better for the patients in group A than those in group B, and so preoperative management is useful for HLHS patients, especially those with moderate or severe TR at admission, with the exception of severe dysplasia of tricuspid valve.

AB - Background: Tricuspid regurgitation (TR) is an important finding in hypoplastic left heart syndrome (HLHS). The aim of the present study was to investigate changes in the degree of TR after the preoperative management of HLHS with mechanical ventilation, and whether the improvement of TR under preoperative management would affect the short-term prognosis of Norwood operation. Methods: Clinical and echocardiographic data of 55 patients with HLHS who underwent preoperative echocardiography and management at Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, were retrospectively reviewed. Preoperative management with mechanical ventilation was performed in 31 of these patients. Based on echocardiography the 55 patients were divided into a trivial-mild TR group (group A) and a moderate-severe TR group (group B). Results: After preoperative management, TR improved in six of the 31 patients and was unchanged in 25; in five of the nine group B patients, TR before management improved to the level of group A after management. In-hospital deaths after surgery included 17 of the 48 patients in group A and five of the six in group B, but there was only one death in the five patients for whom TR improved from group B to group A level. Conclusion Preoperative management of HLHS resulted in an improvement in the degree of TR. The short-term prognosis was better for the patients in group A than those in group B, and so preoperative management is useful for HLHS patients, especially those with moderate or severe TR at admission, with the exception of severe dysplasia of tricuspid valve.

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