THE MODIFIED NORWOOD PROCEDURE FOR HYPOPLASTIC LEFT HEART SYNDROME: FIRST EXPERINCE OF USING THE «KEMANGIOPROTEZ» VASCULAR XENOGRAFT

Highlights

The article presents a unique clinical case of correction of hypoplastic left heart syndrome with Norwood procedure using a “KemAngioprosthesis” vascular xenograft as a Sano shunt.

Abstract

We present the first successful clinical case of using the “KemAngioprosthesis” vascular xenograft in the pulmonary position as the Sano shunt in the Norwood procedure for correction of hypoplastic left heart syndrome. A newborn baby (gestation period of 38 weeks) diagnosed with congenital heart disease, and hypoplastic left heart syndrome was admitted to the Research Institute for Complex Issues of Cardiovascular Diseases. The child survived the first stage of the modified Norwood procedure (Sano shunt) using a biological vascular prosthesis. This clinical case showed that using the “KemAngioprosthesis” vascular xenograft in Norwood procedure to modify pulmonary blood flow by creating an anastomosis between the right ventricle and bifurcation of the pulmonary artery is effective and safe in the short-term period.

1. Lev M. Pathologic anatomy and interrelationship of hypoplasia of the aortic tract complexes. Lab Invest. 1952;1(1):61-70.

2. Noonan JA, Nadas AS. The hypoplastic left heart syndrome; an analysis of 101 cases. Pediatr Clin North Am. 1958 Nov; 5(4): 1029-1056. doi: 10.1016/s0031-3955(16)30727-1

3. Tchervenkov C.I., Jacobs J.P., Weinberg P.M., Aiello V.D., Béland M.J., Colan S.D., Elliott M.J., Franklin R.C., Gaynor J.W., Krogmann O.N., Kurosawa H., Maruszewski B., Stellin G. The nomenclature, definition and classification of hypoplastic left heart syndrome. Cardiol Young. 2006 Aug; 16 (4): 339-368. doi: 10.1017/S10479511060002912

4. Kirklin J.W., Barratt-Boyes B.G. Aortic atresia and other forms of hypoplastic left heart physiology. In: Kirklin J.W., Barratt-Boyes B.G. (eds). Cardiac Surgery. Fourth edition, 2013, p 1780–1809.

5. Hunter L.E., Simpson J.M. Prenatal screening for structural congenital heart disease. Nat Rev Cardiol. 2014 Jun; 11 (6): 323-334. doi: 10.1038/nrcardio.2014.34

6. Pediatric Cardiac Surgery FOURTH EDITION Editor Constantine Mavroudis MD This edition first published 2013, © 2013 by Blackwell Publishing Ltd

7. Metcalf MK, Rychik J. Outcomes in Hypoplastic Left Heart Syndrome. Pediatr Clin North Am. 2020 Oct;67(5):945-962. doi: 10.1016/j.pcl.2020.06.008

8. Connor J.A., Thiagarajan R. Hypoplastic left heart syndrome. Orphanet J Rare Dis. 2007 May 11;2:23. doi: 10.1186/1750-1172-2-23

9. Roeleveld P.P., Axelrod D.M., Klugman D., Jones M.B., Chanani N.K., Rossano J.W., Costello J.M. Hypoplastic left heart syndrome: from fetus to fontan. Cardiol Young. 2018 Nov;28(11):1275-1288. doi: 10.1017/S104795111800135X

10. Hunter L.E., Simpson J.M. Prenatal screening for structural congenital heart disease. Nat Rev Cardiol. 2014 Jun; 11 (6): 323-334. doi: 10.1038/nrcardio.2014.34

11. Свободов А.А., Беришвили Д.О., Калашников С.В., Горбачевский С.В., Дидык В.П., Зеленикин М.М., Ким А.И., Кокшенев И.В., Крупянко С.М., Кривощеков Е.В., Метлин С.Н., Мовсесян Р.Р., Сабиров Б.Н., Туманян М.Р., Шаталов К.В., Шмальц А.А., Юрлов И.А. Клинические рекомендации 2018. Синдром гипоплазии левых отделов сердца. Режим доступа: https://racvs.ru/upload/iblock/d2f/d2fb9a05076a167ab443d0957c1701ec.pdf (дата обращения 1.04.2023)

12. Sano S., Ishino K., Kawada M., Arai S., Kasahara S., Asai T., Masuda Z., Takeuchi M., Ohtsuki S. Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2003 Aug; 126 (2): 504-509. doi: 10.1016/s0022-5223(02)73575-7

13. Режим доступа: https://neocor.ru/arterii-nizhnikh-konechnostey-products

14. [Zhuravleva I.Ju., Glushkova T.V., Veremeev A.V., Hrjachkova O.N., Loseva S.V., Barbarash L.S. Primenenie aminodifosfonata dlja profilaktiki kal'cifikacii jepoksiobrabotannyh bioprotezov. Patologija krovoobrashhenija i kardiohirurgija. 2010. № 2. S. 18-21. (In Russ)

15. [Barbarash L.S., Burkov N.N., Kudrjavceva Ju.A., Anufriev A.I., Zhuravleva I.Ju. Sravnitel'nyj analiz primenenija bioprotezov arterij s razlichnoj antitromboticheskoj modifikaciej. Angiologija i sosudistaja hirurgija. 2012. T. 18. № 2. S. 21-25. (In Russ)]

16. [Barbarash L. S., Ivanov S. V., Zhuravleva I. Ju., Anufriev A. I., Kazachek Ja. V., Kudrjavceva Ju. A., Zinec M. G. 12-letnij opyt ispol'zovanija bioprotezov dlja zameshhenija infraingvinal'nyh arterij. Angiologija i sosudistaja hirurgija tom 12 №3/2006.(In Russ)]

17. [Sukovatykh BS, Belikov LN, Rodionov AO, Sukovatykh MB, Grigorian AYu. Effectiveness of biological prosthesis for femoro-femoral bypass in high risk patients. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2018;(5):86‑90. (In Russ.)]

18. [Burkov NN, Kazantsev AN, Anufriev AI, Danilovich AI, Smirnov KV, Lider RYu, Bayandin MS, Evtushenko AV. Femoropopliteal reconstruction with 'KemAngioprotez' biological prosthesis. Kardiologiya i Serdechno-Sosudistaya Khirurgiya. 2020;13(1):29‑35. (In Russ.)]