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Clinical Outcomes, Program Evolution, and Pulmonary Artery Growth in Single Ventricle Palliation Using Hybrid and Norwood Palliative Strategies  Osami.

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Presentation on theme: "Clinical Outcomes, Program Evolution, and Pulmonary Artery Growth in Single Ventricle Palliation Using Hybrid and Norwood Palliative Strategies  Osami."— Presentation transcript:

1 Clinical Outcomes, Program Evolution, and Pulmonary Artery Growth in Single Ventricle Palliation Using Hybrid and Norwood Palliative Strategies  Osami Honjo, MD, PhD, Lee N. Benson, MD, Holly E. Mewhort, BSc, Dragos Predescu, MD, Helen Holtby, MD, Glen S. Van Arsdell, MD, Christopher A. Caldarone, MD  The Annals of Thoracic Surgery  Volume 87, Issue 6, Pages (June 2009) DOI: /j.athoracsur Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Clinical outcomes of the patients who underwent hybrid or Norwood-type single ventricle palliation. (BCPS = bidirectional cavopulmonary shunt.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Angiograms at pre–stage 2 cardiac catheterization in hybrid and Norwood groups. (A) Bilateral branch pulmonary arteries are demonstrated by selective injection into the Blalock-Taussig shunt in a Norwood patient. (B, C) Selective angiograms of branch pulmonary arteries in a hybrid patient are shown. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 The graph showing Nakata index (A) and lower lobe index (B) at pre–stage 2 catheterization in hybrid and Norwood groups. Nakata index and lower lobe index are equivalent between the groups. Vertical bars represent standard deviation and horizontal bars across boxes represent median values. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Echocardiographic findings at pre–stage 2 evaluation in (A) hybrid group (n = 15) and (B) Norwood group (n = 27). One dot represents 1 patient. (AVVR = atrioventricular valve regurgitation.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Bar graph showing the comparisons of combined (stage 1 and stage 2) intubation time and length of stay (LOS) in the intensive care unit (ICU) and hospital between the groups. The hybrid group (gray bars) has a significantly shorter intubation time and length of stay in the ICU and hospital (*p < 0.05) compared with the Norwood group (black bars). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Correlation graphs showing the time-related trends toward improvements in resource utilization, including intubation time, length of intensive care unit (ICU) stay and hospital stay comparing stage 2 hybrid versus stage 1 Norwood procedure. The x-axis represents calendar dates and the y-axis represents duration of the resource utilization. There are weak negative correlations between time and duration of resource utilization in the hybrid group, but no such trends are seen in stage 1 Norwood procedure. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions


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