Single-center experience of arch reconstruction in the setting of Norwood operation

The Annals of Thoracic Surgery
Takahisa SakuraiWilliam J Brawn

Abstract

Arch reconstruction is a key part of the Norwood operation for hypoplastic left heart syndrome and is related to late morbidity. Since 2003, our surgical technique has been standardized to a right ventricle to pulmonary artery conduit, arch reconstruction with homograft patch, and Damus-Kaye-Stansel anastomosis onto homograft patch, with partial or complete resection of any coarctation ridge. We studied the impact of the surgical approach on arch reinterventions and outcome. A retrospective review of echocardiogram, catheterizations, and hospital records of patients who underwent stage1 reconstruction from January 2003 to December 2010 was performed. A total of 289 patients underwent stage 1 reconstruction during this period. Age and body weight at operation were 9.3 ± 25 days and 3.1 ± 0.6 kg. Early survival was 86%. Seventy-three patients (25%) underwent intervention for recoarctation: balloon angioplasty (n = 68) or surgical intervention (n = 11). Eighteen patients underwent multiple interventions for recoarctation. Size of ascending aorta and incomplete resection of ductal tissue were risk factors for reintervention (p = 0.01 and p = 0.02). Patients with an ascending aorta diameter less than 2 mm had significantly higher re...Continue Reading

References

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Citations

Aug 2, 2014·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Allison K BlackBradley B Keller
Apr 2, 2014·The Journal of Thoracic and Cardiovascular Surgery·Alexander A BresciaCharles B Huddleston
Jun 21, 2015·The Journal of Thoracic and Cardiovascular Surgery·Tomomi HasegawaShunsuke Matsushima
May 10, 2013·Seminars in Cardiothoracic and Vascular Anesthesia·Michael ShillingfordMark Bleiweis
May 9, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Nandhini RavintharanMelissa G Y Lee
Jan 24, 2019·The Journal of Thoracic and Cardiovascular Surgery·Paul J DevlinTara Karamlou
Jun 9, 2020·The Annals of Thoracic Surgery·Muhammad Owais Abdul GhaniDavid P Bichell

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