Aortic arch reconstruction in the Norwood procedure using a curved polytetrafluorethylene patch

Area of Science:

• Congenital Heart Surgery
• Pediatric Cardiac Surgery
• Cardiovascular Surgery

Background:

• The Norwood procedure is a critical intervention for hypoplastic left heart syndrome (HLHS).
• Aortic arch reconstruction typically uses homograft patches, but alternatives are being explored.
• The use of artificial vascular prosthesis patches is investigated for aortic arch enlargement.

Purpose of the Study:

• To evaluate the outcomes of using curved polytetrafluoroethylene (PTFE) patches as an alternative to homograft patches in aortic arch reconstruction during the Norwood procedure.
• To compare the postoperative course and long-term follow-up results between PTFE and homograft patches.

Main Methods:

• A retrospective analysis of 224 Norwood patients operated between April 2007 and April 2018.
• Patients were divided into two groups: 104 received PTFE patches (group PTFE) and 120 received pulmonary homograft patches (group homograft).
• Data collected included postoperative course, aortic arch interventions, and reoperations.

Main Results:

• No material-associated operative or postoperative complications were observed.
• In-hospital mortality was 13% in the PTFE group.
• Late mortality was 6% in the PTFE group, with one case of aortic isthmus dilatation and no arch reoperations during follow-up.

Conclusions:

• Curved PTFE patches demonstrate favorable operative technical characteristics.
• PTFE patches provide excellent long-term results in selected HLHS patients.
• PTFE patches can serve as a suitable alternative to pulmonary homografts for aortic arch reconstruction in specific cases.