Ergin Arslanoğlu1, Kenan Abdurrahman Kara1, Ali Can Hatemi2, Berra Zümrüt Tan1, Ömer Faruk Şavluk3, Fatma Ukil Işıldak3, Eylem Tunçer1, Nihat Çine1, Hakan Ceyran1

1Department of Pediatric Cardiovascular Surgery, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
2Department of Pediatric Cardiovascular Surgery, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey
3Department of Anaesthesiology and Reanimation, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey

Keywords: Gestational age; norwood; pediatric heart surgery.


Introduction: The Norwood operation performed for hypoplastic left heart syndrome in the neonatal period remains to be a high-risk and difficult surgical procedure. It is known that preterm birth often accompanied by low birth weight is associated with high mortality and morbidity in these patients.

Patients and Methods: The study included 54 patients who underwent the Norwood procedure in our clinic in the period between December 2012 and December 2019. Patient data were evaluated retrospectively; in- cluding gestational week, age, body weight, total bypass time, aortic cross-clamp time, extubation time, the length of stay in the intensive care unit, the length of hospital stay, and the preoperative and postoperative levels of urea, creatinine, alanine aminotransferase, aspartate aminotransferase, and platelet counts.

Results: The body weight of the patients ranged from 2350 to 4500 grams with an average of 3296.3 ± 486.7 grams. The age of the patients at the time of operation ranged from 1 to 374 days with an average of 30.31 ± 70.51 days. The comparison of patients by term pregnancies resulted in no statistically significant differences but the comparison by gestational weeks revealed a statistically significant result.

Conclusion: Preoperative risk factors affect prognosis more than the surgical technique and the treatment approach in patients with a functional single ventricle. When the gestational week was evaluated as a preop- erative risk factor for its effects on the postoperative prognosis of stage 1 Norwood operation in our study, it was found that mortality decreased significantly after the 38.8th gestational week (272 gestational days).

Cite this article as: Arslanoğlu E, Kara KA, Hatemi AC, Tan BZ, Şavluk ÖF, Ukil Işıldak F, et al. The importance of gestational age as a prognostic factor on norwood stage 1 outcome. Koşuyolu Heart J 2021;24(Suppl 1):S18-S25.

Ethics Committee Approval

The study protocol was approved by the local ethics committee. The study was conducted in accordance with the principles of the Declaration of Helsinki (2021/4/457).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - EA; Analysis/Interpretation - KK; Data Collection - AH; Writing - EA, KK; Critical Revision - BT; Final Approval - HC; Statistical Analysis - FI, ET; Obtained funding - ÖŞ; Overall Responsibility - NÇ, HC.

Conflict of Interest

The authors have no conflicts of interest to declare

Financial Disclosure

The authors declared that this study has received no financial support.