Innominate artery patency after direct cannulation in neonates

Area of Science:

• Pediatric Cardiology
• Congenital Heart Surgery
• Vascular Surgery

Background:

• The Norwood procedure is a critical intervention for complex single-ventricle congenital heart disease.
• Direct innominate artery cannulation is a surgical technique used during the Norwood procedure.
• Innominate artery stenosis is a potential complication that requires evaluation.

Purpose of the Study:

• To determine the short-term incidence of innominate artery stenosis.
• To assess the occurrence of stenosis in neonates after direct innominate artery cannulation during the Norwood procedure.

Main Methods:

• Retrospective review of 92 neonates undergoing the Norwood procedure with direct innominate artery cannulation (2006-2017).
• Primary outcome: angiographic evidence of innominate artery patency at pre-Glenn cardiac catheterization.
• Data collected: patient characteristics, surgical measurements, hemodynamic data, and postoperative neurologic findings.

Main Results:

• Mild innominate artery stenosis was found in 5 of 92 patients (5.4%) at a median of 3 months post-procedure.
• No moderate or severe innominate artery stenosis was observed.
• No clinically significant stenosis or reintervention was noted in follow-up records.

Conclusions:

• Direct innominate artery cannulation during the Norwood procedure is associated with a low incidence of innominate artery stenosis in neonates.
• Clinically significant innominate artery stenosis did not occur in this patient cohort.
• The findings suggest that direct innominate artery cannulation is a relatively safe technique regarding short-term innominate artery stenosis.