In this article we analyze the impact of aortic arch repair on the development of aortic obstruction when using a Norwood procedure. Patients were divided into two groups. Group 1 included patients who underwent neoaortic plasty performed by using bovine pericardial patches (group 1, n = 6). Group 2 consisted of patients, whose arch was repaired with autologous tissues only, without using bovine pericardial (group 2, n = 12). The groups were comparable by demographic data. To measure the aorta, we used cardiac catheterization data obtained before stage 2 of hemodynamic correction. Angiographic measurements were carried out at the level of distal anastomosis and descending aorta. Coarctation index (CI) was calculated as the ratio between distal anastomosis on neoaorta and descending aorta. Occurrence of aortic obstruction in groups 1 and 2 was 50% (n = 3) and 16.7% (n = 2) respectively (p = 0.137). The aorta at the level of distal anastomosis was greater in group 2 if compared with group 1. Differences between the two groups were not statistically significant. CI for groups 1 and 2 were 0.730.16 and 0.90.18 respectively (p = 0.08). When comparing patients with the obstruction of the aortic arch and without it, the presence of ductus arteriosus tissue was found out to be associated with stenosis (p = 0.019). The authors believe that the complete excision of coarctation tissue is one of the keys to prevention of postoperative aortic arch obstruction.

The study centered on the possibility of surgery on the atrial septum (AS) without aortic clamping and cardiac arrest. We compared two groups of patients who underwent intervention on AS as the major or concomitant stage of surgical treatment. Nineteen patients were assigned to the main group; they were operated under CPB without aortic clamping and cardioplegia. The control group consisted of 20 patients, whose AS was surgically treated by using a standard technique with aortic occlusion. The groups were comparable by age and disease. The patients of both groups withstood the surgical interventions satisfactorily, with no mortality. The mean CBP time in the patients operated without aortic clamping was shorter than that in the control group patients (operated with aortic clamping) by about 18-20 minutes. The major surgical stage time did not differ between the groups. The technique of atrial septal defect closure or its dissection on the beating heart without cardioplegia is safe, comfortable for a surgeon and allows saving time required for the recovery period. Besides, it does not cause myocardial lesion associated with cardioplegia.