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ID 62306
著者
Kobayashi, Yasuyuki Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University ORCID Kaken ID
Kotani, Yasuhiro Department of Cardiovascular Surgery, Okayama University Hospital
Kawabata, Takuya Department of Cardiovascular Surgery, Okayama University Hospital
Kuroko, Yosuke Department of Cardiovascular Surgery, Okayama University Hospital
Sano, Shunji Department of Pediatric Cardiothoracic Surgery, University of California
Kasahara, Shingo Department of Cardiovascular Surgery, Okayama University Hospital Kaken ID publons
抄録
OBJECTIVES
This study aimed to evaluate whether recoarctation of the aorta (reCoA) after the Norwood procedure for hypoplastic left heart syndrome correlates with pre- and postoperative anatomic factors.

METHODS
This retrospective study included 48 patients who underwent Norwood procedure with right ventricle-to-pulmonary artery conduit between 2009 and 2017. Anatomical factors such as preoperative length, diameter of the main pulmonary artery (MPA), and postoperative neoaortic arch angle stratified by arch reconstruction technique were analysed using the receiver operating characteristic analysis.

RESULTS
Eleven patients needed surgical intervention for reCoA at stage 2. Out of the 30 patients who underwent direct anastomosis during arch reconstruction, 7 developed reCoA. Seven patients received the full patch augmentation (patch augmentation for both lesser and greater curvatures) and were all spared from reCoA. Among the patients who had direct anastomosis, the preoperative MPA length was correlated with the postoperative arch angle (P = 0.021) and was associated with the occurrence of reCoA (P = 0.002) and the best cutoff value for MPA length was 10 mm. The postoperative arch angle was also correlated with the incidence of reCoA (P < 0.001) and was larger in patients who underwent the full patch augmentation than in patients who had direct anastomosis (126° vs 112°, P = 0.005) despite comparable MPA length.

CONCLUSIONS
ReCoA after the Norwood procedure correlates with MPA length when a direct anastomosis was used. Direct anastomosis can be considered in patients with a longer preoperative MPA. In other cases, the full patch augmentation should be considered for obtaining a large and smooth neoaortic arch.
キーワード
Hypoplastic left heart syndrome
Norwood
Recoarctation
Direct anastomosis
備考
This is an Accepted Manuscript of an article published by Oxford University Press. This fulltext is available in June 2022.
発行日
2021-6-24
出版物タイトル
Interactive CardioVascular and Thoracic Surgery
出版者
Oxford University Press (OUP)
ISSN
1569-9293
資料タイプ
学術雑誌論文
言語
English
OAI-PMH Set
岡山大学
PubMed ID
DOI
関連URL
isVersionOf https://doi.org/10.1093/icvts/ivab170