Abstract 15907: Patch Material Does Impact Reintervention After Aortic Arch Reconstruction: Single Center Experience

Abstract

Objective: to evaluate reintervention rates after primary aortic arch reconstruction according to patch material. Methods: Patients undergoing primary surgical repair from October 2004 to December 2021 were identified. Univentricular physiology anatomies were excluded. Comparative analysis was performed between Homograft (81%), and Bovine pericardium (19%). The primary outcome was surgical or catheter-based reintervention. Kaplan-Meier function and Cox-regression analysis were used. Results: we included 160 patients with a median age and weight of 14 days (IQR 7-53) and 3.3 kg (IQR 2.9 - 4.2). The median follow-up time was 6.4 years (IQR 2.8 - 10.4). The clinical breakdown was Hypoplastic Aortic Arch/Aortic Coarctation in 89% (n=142) and Interrupted Aortic Arches in 10% (n= 17) (Table 1). Overall, 25% patients (n= 40) underwent a reintervention; 80% (n= 32) were balloon dilation angioplasties. After 1-, 5-, and 10-years post op, 78%, 74%, 72% of patients survived without reintervention, respectively. No differences were observed in the cumulative hazard between homograft and Bovine pericardium patch repairs (Figure 1). Multivariable cox regression showed an increased hazard for reintervention for bovine pericardium patches (HR 2.9, 95% CI 1.1 - 8.0) after controlling for age, weight, diagnosis, aortic arch, and aortic isthmus Z-Scores. Conclusion: Intermediate term outcomes after aortic arch reconstruction are favorable in a single center. Patch material is likely to be an important determinant for the risk of early restenosis requiring reintervention after aortic arch reconstruction.