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Modifizierte Norwood-Stage-I-Operation

Mögliche operative Technik bei hypoplastischem Linksherzsyndrom

Modified Norwood stage I operation

Possible operative technique for hypoplastic left heart syndrome

  • Operative Techniken
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

In den letzten Jahren unterlag kein kongenitaler Herzfehler einem grundlegenderen Wandel hinsichtlich prä- und perinataler Diagnostik, perioperativem Management, im Besonderen der chirurgischen Technik, sowie kurz- und langfristigem Outcome als das hypoplastische Linksherzsyndrom (HLHS). In der Vergangenheit variierte das Überleben der betroffenen Kinder bis zum 5. Lebensjahr (Norwood-Stage-III-Operation eingeschlossen) zwischen 50 % und 65 %. Aktuelle Berechnungen gehen davon aus, dass heute 80 % der Neugeborenen mit HLHS das Erwachsenenalter erreichen werden. Obwohl die klassische 3‑Stufen-Palliation zur Behandlung des HLHS etabliert ist, gibt es dennoch signifikante Unterschiede bezüglich des chirurgischen Vorgehens zwischen den Zentren. Im vorliegenden Beitrag wird eine mögliche operative Technik (Norwood-Stage-I-Operation) zur Palliation des HLHS vorgestellt.

Abstract

In recent years no congenital heart malformation has undergone a more dramatic change with respect to prenatal and perinatal diagnostics, perioperative management, particularly the surgical technique as well as short and long-term outcomes than hypoplastic left heart syndrome (HLHS). In the past survival of affected children up to the age of 5 years (including Norwood stage III operations) varied from 50% to 65%. Current expectations are that 80% of neonates born with HLHS will reach adulthood. Although the classical 3‑stage palliation for treatment of HLHS is established, there are nevertheless significant differences between the centers with respect to the surgical approach. In this article a possible operative technique (Norwood stage I operation) for palliation of HLHS is presented.

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Authors and Affiliations

  1. Sana Herzchirurgie Stuttgart, Zentrum für angeborene Herzfehler Stuttgart, Zertifiziertes überregionales EMAH-Zentrum, Herdweg 2, 70174, Stuttgart, Deutschland

    M. Liebrich, M. Schweder, A. Diegeler, A. Narr, A. Gomes de Sena, N. Doll & I. Tzanavaros

  2. Serviḉo de Cirurgia Cardiotorácica, Hospital de Santa Maria, Lissabon, Portugal

    A. Gomes de Sena

  3. Klinik für Kinderkardiologie, Pulmonologie und Intensivmedizin, Olgahospital Stuttgart, Stuttgart, Deutschland

    T. Eberle, S. Dähmlow, U. Schweigmann, V. Ocker & F. Uhlemann

  4. Abteilung für Kinderkardioanästhesie, Sana Herzchirurgie Stuttgart, Stuttgart, Deutschland

    C. Schepp & T. Röhl

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  1. M. Liebrich
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Correspondence to M. Liebrich.

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Interessenkonflikt

M. Liebrich, M. Schweder, A. Diegeler, A. Narr, A. Gomes de Sena, T. Eberle, S. Dähmlow, U. Schweigmann, V. Ocker, F. Uhlemann, C. Schepp, T. Röhl, N. Doll und I. Tzanavaros geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Liebrich, M., Schweder, M., Diegeler, A. et al. Modifizierte Norwood-Stage-I-Operation. Z Herz- Thorax- Gefäßchir 32, 459–470 (2018). https://doi.org/10.1007/s00398-018-0269-z

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  • DOI: https://doi.org/10.1007/s00398-018-0269-z

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