Fisiologia aplicada ao tratamento atual do recém-nascido com síndrome de hipoplasia do coração esquerdo

Mailing Address: Fernando Antibas Atik – The Cleveland Clinic Foundation – 9500 Euclid Avenue H35 Cleveland, Ohio 44195 – USA Email: fernandoatik@aol.com Received in 06/07/05 Accepted in 12/09/05 The surgical treatment of hypoplastic left heart syndrome is still a challenge. Few selected large volume centers that adopted protocols focused on understanding of post-Norwood pathophysiology have reduced their mortality rates to around 15%. The inherent inefficacy of the parallel circulation in Norwood operation lends itself to problems related to postoperative management of these patients crucially revolving around keeping a balance between systemic blood flow (Qs) and pulmonary blood flow (Qp). This paper describes the physiology of the Norwood principle, the importance of an adequate hemodynamic assessment, to guide the different postoperative management options.