|
|
||
|
|
||
|
|
||
|
|
||
|
|
||
|
|
||
The result gives the predicted difference in percent survival for Norwood minus biventricular repair. A positive number would therefore favor a Norwood procedure and a negative number would favor a biventricular repair, with the magnitude of the number representing the predicted difference in percent survival or the survival benefit for the optimal pathway.
Critical left ventricular outflow obstruction was defined as
the presence of moderately or severely reduced left ventricular
function or the presence of systemic perfusion dependent on
right ventricular output via a patent arterial duct.
All patients had to have important left ventricular outflow obstruction or
hypoplasia with concordant atrioventricular and ventriculoarterial
connections, with echocardiographic, angiographic, or surgical demonstration of patency of the aortic valve.
Patients with large ventricular septal defects or associated cardiac
anomalies judged to be of worse prognostic significance than
their left ventricular obstructive lesions were excluded.
Measured in the PLAX view;
maximal antero-posterior diameter of aortic root at level of sinuses of Valsalva, inner edge to inner edge.
The default aortic root z-score equation is that of Daubeney et al. (Wessex data)
The alternate equation is that of Colan et al. (Boston data).
(see citations below)
(EFE = endocardial fibroelastosis)
Graded from all views;
Mild = involves only papillary muscle area
Moderate = papillary muscle and some part of LV endocardium
Severe = extensive endocardial involvement
Measured in the PLAX view;
maximum diameter (systole), inner surface
"Measured at level above sinotubular junction"
Estimated from AP4C & PSSAX views;
"From color flow Doppler"
Measured in AP4C view (diastole);
Ventricular length from midpoint of plane of mitral valve annulus to apex of LV
Critical aortic stenosis in the neonate: A multi-institutional study of management, outcomes, and risk factors.
Lofland GK, McCrindle BW, Williams WG, Blackstone EH, Tchervenkov CI, Sittiwangkul R, Jonas RA.
J Thorac Cardiovasc Surg. 2001 Jan;121(1):10-27.
Relationship of the dimension of cardiac structures to body size: an echocardiographic study in normal infants and children.
Daubeney PE, Blackstone EH, Weintraub RG, Slavik Z, Scanlon J, Webber SA.
Cardiol Young. 1999 Jul;9(4):402-10.
Validation and Re-Evaluation of a Discriminant Model Predicting Anatomic Suitability
for Biventricular Repair in Neonates With Aortic Stenosis
Steven D. Colan, Doff B. McElhinney, Elizabeth C. Crawford, John F. Keane, and James E. Lock
J. Am. Coll. Cardiol. 2006;47;1858-1865