Early results of aortic arch reconstruction and  bilateral pulmonary artery banding: modification  of the Norwood operation for treatment  of hypoplastic left heart syndrome

Pająk, Jacek; Buczyński, Michał; Stanek, Piotr; Zalewski, Grzegorz; Wites, M; Szydłowski, Lesław; Tomkiewicz‐Pająk, Lidia

doi:10.5603/kp.a2018.0025

Cited by 1 publication

(1 citation statement)

References 19 publications

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“…Being advocates of the Matrix patch, Pająk and colleagues [21] presented excellent results and superior early outcomes comparing the use of Matrix patches to homograft and bovine pericardial patches, thus reducing the risk of postoperative bleeding and potentially improving mortality. On the other hand, Rosario-Quinones and associates reported on a reaction to implanted porcine patches that may cause hemodynamic dysfunction and produce an intense, predominantly eosinophilic in ammatory response with developing brosis [22].…”

Section: Different Arch Reconstruction and Techniquesmentioning

confidence: 99%

“Less patch more growth?”: comparing two different schools of thought in aortic arch reconstruction techniques during Norwood I

Uzdenov¹,

Ballazhi²,

Kroll³

et al. 2023

Preprint

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Background: We compared two different philosophies at one institution with respect to arch-geometry and clinical results: no/minimal patch vs. abundant patch augmentation. Methods: Single center retrospective analysis of the interstage angiographies of 82 patients: 41 (50%) underwent stage I Norwood-type palliation with minimal/no patch material for arch augmentation (Group 1, 2001-2011), and 41 (50%) with an abundant use of patch material (Group 2, 2011-2019). Aortic arch angle, distal arch:descending ratio, planimetry of whole arch, left hilar space were quantified. Clinical endpoints were all interstage interventions on the aortic arch, left pulmonary artery and readmissions due to left lung atelectasis and respiratory failure. Results: Arch angles were more acute in Group 1 (81°±13,2 vs. 90°±10,28, P = .012), with no difference in left hilar space (0,28±0,08 vs. 0,29±0,06, P = .43). Distal arch:descending ratio was smaller in Group 1 (0,72±0,2 vs 0,86±0,19, P = .04). Interstage interventions on the aortic arch and descending aorta were provided in 17 (41,5%) patients in Group 1 versus 19 (46,3%) patients in Group 2. Transcatheter interventions on the left pulmonary artery were necessary in 18 Group 1 patients versus 18 Group 2 patients (43,9%). Unilateral left lung atelectasis and respiratory failure occurred in 2 patients (4,4%) in Group 1 and in 3 patients (7,3%) in Group 2. Conclusions: Abundant patch material is associated with less acute aortic arch angles and leads to significantly better distal arch growth. However, this theoretical geometric benefit did not lead to greater left hilar space, nor did it prove to be superior with respect to interstage-interventions on left hilar structures. Mid-term no clinical effect was detected but future long-term effects are substantial.

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Section: Different Arch Reconstruction and Techniquesmentioning

confidence: 99%

“Less patch more growth?”: comparing two different schools of thought in aortic arch reconstruction techniques during Norwood I

Uzdenov¹,

Ballazhi²,

Kroll³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Early results of aortic arch reconstruction and bilateral pulmonary artery banding: modification of the Norwood operation for treatment of hypoplastic left heart syndrome

Abstract: The introduction of this new surgical technique reduced postoperative bleeding rates, shortened the operation time, and might improve the mortality rate in the first-stage surgical treatment of children with HLHS.

Cited by 1 publication

References 19 publications

“Less patch more growth?”: comparing two different schools of thought in aortic arch reconstruction techniques during Norwood I

“Less patch more growth?”: comparing two different schools of thought in aortic arch reconstruction techniques during Norwood I

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