Original articlePediatric cardiacCan the Kawashima Procedure Be Performed in Younger Patients?
Section snippets
Demographics
A retrospective review of all patients less than 18 years of age undergoing a Kawashima procedure at Childrens Hospital Los Angeles from October 2000 to April 2008 was performed. Both inpatient and outpatient charts were reviewed following guidelines established by the Institutional Review Board. Demographic data regarding gender, cardiac morphology, presence of asplenia-polysplenia (based on spleen scan), and bilateral SVC and initial surgical palliation were tabulated.
Operative Description
Preoperative data
Demographics
Among the 15 patients that met criteria, 11 were male. All patients had heterotaxy and an unbalanced AV septal defect. Additional cardiology morphology for each patient is detailed in Table 1. Data with respect to splenic abnormalities, presence of bilateral SVC, and side of azygous continuation are shown in Table 1. As detailed in Table 1, 13 of 15 patients underwent initial palliation prior to KP. Of the 6 patients who underwent Blalock-Taussig (BT) shunt placement with restriction of
Appropriate Age for Kawashima
Many centers have demonstrated that the Kawashima procedure can be performed safely in patients who are more than 1 year of age [2, 3, 7]. A recent series from Indiana documented 21 patients undergoing their KP at a median age of 2 years and a median weight of 11.2 kg [2]. Similarly, in a large series from Boston, 36 patients underwent KP with one cohort of 16 patients (who subsequently developed post-KP PAVMs) undergoing their procedure at a median age of 10 months, while a second cohort with
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