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Articles

Title: Diagnostic evaluation and treatment in newborns with single ventricle

Author:
Beata Kucińska, Maria Wróblewska-Kałużewska, Bożena Werner, Katarzyna Penconek, Tomasz Floriańczyk, Krzysztof Godlewski
Type:
Original articles
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2002
Volume:
4
Number:
3
Start page:
243
Final page:
249
ISSN:
1507-5540
Keywords:
newborn, single ventricle, diagnostic trial, palliative treatment
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Background: The term "single ventricle" encompasses several types of congenital heart malformations with absent or underdeveloped ventricle. Their complexity leads to many diagnostic problems and imposes the need for precise anatomie and hemodynamic assessment before palliative surgical treatment. Aim: The aim of the study was to analyse the clinical presentation, diagnostic regimen and treatment in 36 newborns (22 boys, 14 girls) with single ventricle hospitalized in Department of Pediatrie Cardiology from 1994 to 2001. Methods: The diagnosis was based on physical examination, X-ray, ECG, ECHO + Doppler and cardiac ca-theterisation in 4 pts. Results: 23 pts were diagnosed with tricuspid atresia (AT), 9 with double-inlet left ventricle (DILV), 1 with double--inlet right ventricle (DIRV) and 3 with pulmonary atresia with intact ventricular septum (AP+IVS). On physical examination the cyanosis dominated in 23 pts with decreased pulmonary flow and signs of heart failu-re were predominant in 6 patients with inereased pulmonary flow. Rashkind procedure was performed in 10 pts with AT and 2 with AP+IVS. Blalock-Taussig anastomosis was done in 21 newborns. Pulmonary banding was performed in 6 pts. 2 pts were operated at the same time for the coaretation of the aorta. 7 pts with AT and one with DILV did not need paliative treatment in newborn period. One patient with AT and generał septicemia died after Rashkind procedurę. Conclusions: The variable clinical presentation in newborns with single ventricle ranges from severe generali-zed cyanosis to severe heartfailure depending on the volume of pulmonaryflow. The type and timing of pal-liative treatment depends on pulmonary flow. About 75% newborns with single ventricle need palliative treatment in newborn period.