Aortic arch reconstruction in newborns with an autologous pericardial patch: contemporary results

Bernabei, Massimo; Margaryan, Rafik; Arcieri, Luigi; Bianchi, Giacomo; Pak, Vitali; Murzi, Bruno

doi:10.1093/icvts/ivs510

Cited by 33 publications

(36 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In their series, re-coarctation occurs in certain cases especially who received autologous pericardium during initial arch repair. 15 Bernabei et al 16 used gluteraldehyde-treated autologous pericardium in their cases for aortic arch repair, and they faced with re-stenosis in some of their cases. Their attempt was to balloon dilate the stenosed arches primarily; however, unsuccessful cases were surgically treated.…”

Section: Discussionmentioning

confidence: 99%

“…They detected an overgrowth of neo-intima to be responsible for the progressive lumen narrowing. 16 In our series, fresh or short-duration gluteraldehyde-treated autologous pericardial materials were used for the treatment of aortic interruption. We faced with pericardial roll dilatation in patients who received fresh tissues both of which presumed to result due to decreased strength of the material at the aortic position as well as additional proximal anastomosis stenosis in one (submitted elsewhere) who was further operated.…”

Section: Discussionmentioning

confidence: 99%

“…1 The residual aortic arch obstruction is not an uncommon pathology and ends up with requirement of the re-intervention in approximately 20% to 40% of the patients who receive aortic interruption repair. 1 Angioplasty may be considered in case of re-stenosis 6,15,16 ; however, the results in the literature reveal that the technique did not reduce the need for surgical reoperation. 1 Figure 3.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll for the treatment of critically ill infants with interrupted aortic arch

et al. 2020

View full text Add to dashboard Cite

Aim: Standard surgical treatment of the interrupted aortic arch with the use of cardiopulmonary bypass is risky especially in critically ill babies. In this manuscript, we present the results of off-pump pericardial roll bypass for the treatment of aortic interruption. Material and methods: The technique was applied in nine critically ill infants between July 2011 and December 2019. Data were reviewed retrospectively. There were four girls and five boys. The types of the interruption were type B in six cases and type A in three babies. Additional cardiovascular anomalies were ventricular septal defect in all, atrial septal defect or patent foramen ovale in all, single-ventricle pathologies in two and bicuspid aortic valve in three cases. All the patients were in critical situations such as intubated, having symptoms of infection, congestive heart failure or ischaemia and malperfusion leading visceral organ dysfunction. Results: All patients underwent off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll. Post-operative early mortality occurred in one patient with severe mitral regurgitation due to cardio-septic shock. One patient who had single-ventricle pathology underwent bidirectional Glenn and was lost on the post-operative 26th day due to sepsis 2 years after operation. Two patients presented with dilatation of the pericardial tube 18 and 24 months after the operations and one underwent reconstruction of the neo-arch. The remaining patients are asymptomatic, active and within normal limits of body and mental growth. Conclusion: Treatment of interrupted aortic arch with a bypass with an autologous pericardial roll treated with gluteraldehyde without cardiopulmonary bypass seems a safe and reliable technique especially for the treatment of critically ill infants.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll for the treatment of critically ill infants with interrupted aortic arch

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In contrast, the reconstruction of the aortic arch is still a challenging part of the Norwood procedure, since recoarctation of the aorta is known to be significantly related to increased morbidity and mortality . Several patch materials such as autologous pericardium, porcine intestinal submucosa, bovine pericardium, and extracellular matrix‐based scaffolds and pulmonary homografts with different geometric designs have been described to achieve the best results in terms of hemodynamics and growth potential . Several advantages and disadvantages of the currently used materials are known and there is no consensus about an ideal patch material for the arch repair in Norwood procedure.…”

Section: Commentmentioning

confidence: 99%

Early results of ring‐reinforced conduit and curved porcine patch in Sano‐Norwood procedure

Yildirim¹,

Bakhshaliyev²,

Kilercik³

et al. 2019

J Card Surg

View full text Add to dashboard Cite

Background Patch augmentation of the aortic arch as well as construction of an unobstructed pulmonary blood supply are two important surgical targets in patients with hypoplastic left heart syndrome. In this report, we aimed to present our preliminary results with a combination of two relatively new approaches in Norwood‐Sano procedure. Methods A retrospective analysis was performed in 10 newborns with the diagnosis of hypoplastic left heart syndrome. Our surgical approach incorporated the interposition of a 6.0‐mm ring‐reinforced tube graft with the “dunked technique” between the right ventricle and the pulmonary artery; and reconstruction of the aortic arch using a curved porcine pericardial patch which is specifically designed for the Norwood procedure. Results Mean age and body weight at the time of the Sano‐Norwood operation were 7.3 ± 2.4 days and 3164 ± 406 g, respectively. We encountered 1 (10%) early and 1 (10%) late mortality. All of the patients were discharged without any residual gradients at the aortic arch. Four out of eight patients underwent stage 2 bidirectional cavopulmonary anastomosis at a median age of 5 months (range, 4‐6 months). Pericardial patch augmentation of the left pulmonary artery was deemed mandatory in one of our patients. Conclusions The dunked technique of interposing a ring‐reinforced conduit between the right ventricle and pulmonary artery along with the utilization of a curved porcine pericardial patch specifically designed for aortic arch reconstruction are promising modifications of the Sano‐Norwood procedure in newborns with hypoplastic left heart syndrome.

show abstract

“…The rate of neoaortic arch reintervention in our study cohort was 11.4% (five reinterventions in 3 patients), lower when compared with several recent published reports. In 2012, Bernabei and colleagues [18] reported an aortic arch reintervention rate of 28.2% after Norwood palliation with the use of autologous pericardial material. A recent report from our institution, from January 2008 to December 2013, demonstrated recurrent arch obstruction in 14% of patients after Norwood palliation with an equal number of patients having homograft and PSIS patch material for arch reconstruction.…”

Section: Commentmentioning

confidence: 99%

Porcine Small Intestinal Submucosa May Be a Suitable Material for Norwood Arch Reconstruction

Jacobsen

Mitchell

Woods

et al. 2018

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

show abstract

Aortic arch reconstruction in newborns with an autologous pericardial patch: contemporary results

Abstract: The use of autologous pericardium in aortic arch reconstruction procedure is effective and associated with an acceptable incidence of recurrent arch obstruction. Its availability and characteristics make it an attractive alternative to other materials.

Cited by 33 publications

References 17 publications

Off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll for the treatment of critically ill infants with interrupted aortic arch

Off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll for the treatment of critically ill infants with interrupted aortic arch

Early results of ring‐reinforced conduit and curved porcine patch in Sano‐Norwood procedure

Porcine Small Intestinal Submucosa May Be a Suitable Material for Norwood Arch Reconstruction

Contact Info

Product

Resources

About