Results of aortic arch reconstruction in neonates and infants

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
L Ben Mime ◽  
M Emmel ◽  
N Sreeram ◽  
K Brockmeier ◽  
G Bennink ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Arch Reconstruction ◽  
Neonates And Infants ◽  
Arch Reconstruction

scholarly journals Reconstruction of the Aortic Arch in Neonates and Infants: The Importance of Patch Material

2021 ◽  
Vol 12 (4) ◽  
pp. 487-491
Author(s):  
Ingrid M. van Beynum ◽  
Serife Kurul ◽  
Thomas Krasemann ◽  
Michiel Dalinghaus ◽  
Pieter van de Woestijne ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Important Determinant ◽  
Primary Repair ◽  
First Year ◽  
Aortic Arch Reconstruction ◽  
Study Population ◽  
Aortic Arch Repair ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
First Year Of Life

Objectives: Restenosis after aortic arch reconstruction is a known complication in neonates and infants. Homograft is the most commonly used patch material for aortic arch reconstructions in our center. Since 2014, tissue-engineered bovine pericardium (CardioCel) has been used as an alternative. The aim of our study was to determine whether the choice of material affected the development of restenosis in these patients. Methods: Data of all neonates and infants who underwent aortic arch reconstruction with the use of any patch material between 2005 and 2016 were analyzed. Restenosis was defined by the need for reintervention, either percutaneous or surgical. Results: Forty-one patients underwent aortic arch repair. Excluding the 30-day mortality, 36 patients represented the study population. At primary repair, the aortic arch was reconstructed with homograft (n = 26) or CardioCel (n = 10). Restenosis was documented during the first year of life in 13 patients: Six (23%) patients in the homograft group and seven (70%) patients in the CardioCel group ( P = .01). In the homograft group, the median time from operation to first intervention for restenosis was 22.0 (range: 14-32) weeks, as compared to 14.0 (range: 7-21) weeks in the CardioCel group ( P = .04). Conclusion: We conclude that choice of patch material is likely to be an important determinant for the risk of restenosis needing reintervention following reconstruction of the aortic arch in neonates and infants.

Contemporary outcomes of aortic arch hypoplasia and coarctation repair in a tertiary paediatric cardiac surgery centre

2021 ◽  
pp. 1-6
Author(s):  
Amr Ashry ◽  
Amer Harky ◽  
Abdulla Tarmahomed ◽  
Christopher Ugwu ◽  
Heba M. Mohammed ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Recurrent Laryngeal Nerve Injury ◽  
Coarctation Repair ◽  
Aortic Arch Reconstruction ◽  
Retrospective Data Collection ◽  
Laryngeal Nerve Injury ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
Aortic Arch Hypoplasia

Abstract Objectives: There are several studies reporting the outcomes of hypoplastic aortic arch and aortic coarctation repair with combination of techniques. However, only few studies reported of aortic arch and coarctation repair using a homograft patch through sternotomy and circulatory arrest with retrograde cerebral perfusion. We report our experience and outcomes of this cohort of neonates and infants. Methods: We performed retrospective data collection for all neonates and infants who underwent aortic arch reconstruction between 2015 and 2020 at our institute. Data are presented as median and inter-quartile range (IQR). Results: The cohort included 76 patients: 49 were males (64.5%). Median age at operation was 16 days (IQR 9–43.25 days). Median weight was 3.5 kg (IQR 3.10–4 kg). There was no 30 days mortality. Three patients died in hospital after 30 days (3.95%), neurological adverse events occurred in only one patient (1.32%) and recurrent laryngeal nerve injury was noted in four patients (5.26%). Only three patients required the support of extracorporeal membrane oxygenation (ECMO) with a median ECMO run of 4 days. Median follow-up was 35 months (IQR 18.9–46.4 months); 5 years survival was 93.42% (n = 71). The rate of re-intervention on the aortic arch was 9.21% (n = 7). Conclusion: Our experience shows excellent outcomes in repairing aortic arch hypoplasia with homograft patch under moderate to deep hypothermia with low in-hospital and 5 years mortality rates.

Gastrostomy Tube Placement in Neonates Undergoing Congenital Heart Surgery: A Novel Assessment for Improving Utilization and Timing of Placement

2021 ◽  
Vol 12 (4) ◽  
pp. 480-486
Author(s):  
Kevin M. Beers ◽  
Aaron Bettenhausen ◽  
Thomas J. Prihoda ◽  
John H. Calhoon ◽  
S. Adil Husain
Keyword(s):  
Length Of Stay ◽  
Aortic Arch ◽  
Congenital Heart ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Genetic Syndrome ◽  
Delayed Sternal Closure ◽  
Aortic Arch Reconstruction ◽  
Gastrostomy Tube Placement ◽  
Arch Reconstruction

Background: Neonates undergoing congenital heart defect repair require optimized nutritional support in the perioperative period. Utilization of a gastrostomy tube is not infrequent, yet optimal timing for placement is ill-defined. The objective of this study was to identify characteristics of patients whose postoperative course included gastrostomy tube placement to facilitate supplemental tube feeding following neonatal repair of congenital heart defects. Methods: A single-institution, retrospective chart review identified 64 consecutive neonates who underwent cardiac operations from 2012 to 2016. Perioperative variables were evaluated for significance in relation to gastrostomy tube placement. Results: A total of 27 (42%) underwent gastrostomy tube placement. Diagnosis of a genetic syndrome was associated with the likelihood of placement of gastrostomy tube ( P = .032), as were patients with single ventricle physiology ( P = .0013) compared to those felt to be amenable to eventual biventricular repair. Aortic arch reconstruction ( P = .029), as well as the need for delayed sternal closure ( P = .05), was associated with increased frequency of gastrostomy tube placement. Postoperative outcomes including the number of days intubated ( P = .0026) and the presence of significant dysphagia ( P = .0034) were associated with gastrostomy placement. Additionally, genetic syndrome ( P = .003), aortic arch reconstruction ( P = .01), and postoperative intubation duration ( P = .0024) correlated with increased length of stay, where increased length of stay was associated with gastrostomy tube placement ( P = .0004). Discussion: Patient characteristics that were associated with a high likelihood of eventual gastrostomy placement were identified in this study. Early recognition of such characteristics in future patients may allow for reduced time to gastrostomy tube placement, which in turn may improve perioperative growth and outcomes.

Comparative experimental study of cerebral protection during aortic arch reconstruction

1996 ◽  
Vol 61 (5) ◽  
pp. 1348-1354 ◽  
Author(s):  
Taku Sakurada ◽  
Teruhisa Kazui ◽  
Hisashi Tanaka ◽  
Sakuzo Komatsu
Keyword(s):  
Experimental Study ◽  
Aortic Arch ◽  
Cerebral Protection ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction

scholarly journals Neonatal Aortic Arch Reconstruction With Direct Splanchnic Perfusion Avoids Deep Hypothermia

2017 ◽  
Vol 104 (6) ◽  
pp. 2054-2063 ◽  
Author(s):  
Muhammad Aanish Raees ◽  
Clinton D. Morgan ◽  
Venessa L. Pinto ◽  
Ashly C. Westrick ◽  
Chevis N. Shannon ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Deep Hypothermia ◽  
Splanchnic Perfusion ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction

scholarly journals ANALYSIS OF THE VISCERAL PERFUSION STRATEGIES DURING INFANT AORTIC ARCH RECONSTRUCTION

2019 ◽  
Vol 8 (3) ◽  
pp. 43-51
Author(s):  
Yu. Yu. Kulyabin ◽  
A. Yu. Omelchenko ◽  
I. A. Soynov ◽  
A. V. Zubritskiy ◽  
A. V. Voytov ◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Aortic Arch ◽  
Nearest Neighbor ◽  
Early Postoperative Period ◽  
The Body ◽  
Lower Body ◽  
Acute Renal Dysfunction ◽  
Open Chest ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction

Aim To compare the effects of continuous regional perfusion methods for infant aortic arch repair on the incidence of acute renal dysfunction and mortality in the early postoperative period.Methods A total of 121 infants who underwent aortic arch reconstruction in the period from June 2007 to December 2017 were included in the study. Patients were 1:1 propensity score matched using the nearest-neighbor methodology. Sixty-two patients (median age 14 (interquartile range (IQR) [8; 23]) days) were selected for the retrospective analysis and divided in two groups: those who underwent repair with selective antegrade cerebral perfusion (SACP) (SACP group, 31 patients) at 23–26°C and those who received whole brain perfusion and additional lower body perfusion (double arterial cannulation (DAC) group, 31 patients) at 28–32°C.Results In-hospital mortality was 3.2% in the DAC group (3.2%) and 12.8% in the SACP group, respectively (p = 0.03). More patients from the SACP group required an open chest after operation (p = 0.013). Patients from the DAC group had shorter open chest duration (p = 0.002) and shorter length of stay in the intensive care unit (ICU) (p = 0.035). There were no differences in the need for renal replacement therapy (p = 0.20) and rate of creatinine level progression during the first three postoperative days between the groups (p = 0.53). The body mass of less than 2 kilos predisposes patients to the onset of acute renal dysfunction (p = 0.013), which was found to be a predictor of early mortality (p = 0.038).Conclusion Lower body perfusion reported similar results to SACP in terms of the onset of acute renal dysfunction, but was superior in terms of lower mortality and shorter lengths of stay in the ICU.

scholarly journals Acute kidney injury and regional abdominal perfusion during neonatal aortic arch reconstruction

2010 ◽  
Vol 140 (2) ◽  
pp. 453-458 ◽  
Author(s):  
Satish K. Rajagopal ◽  
Sitaram M. Emani ◽  
Nathalie Roy ◽  
Lauren Westgate ◽  
Emile A. Bacha
Keyword(s):  
Acute Kidney Injury ◽  
Aortic Arch ◽  
Kidney Injury ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction
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