Autotissue Matrix Patch for Aortic Arch Reconstruction in Congenital Heart Disease—Histology of a Series of Human Explants

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.

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Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies.

Heart ◽

10.1136/hrt.28.6.722 ◽

1966 ◽

Vol 28 (6) ◽

pp. 722-739 ◽

Cited By ~ 202

Author(s):

A R Hastreiter ◽

I A D'Cruz ◽

T Cantez ◽

E P Namin ◽

R Licata

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Arch ◽

Congenital Heart ◽

Right Aortic Arch ◽

Associated Anomalies ◽

Descending Aorta ◽

Right Descending Aorta

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Head Biometry in Fetuses with Isolated Congenital Heart Disease

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0796-6502 ◽

2018 ◽

Vol 41 (01) ◽

pp. 69-76

Author(s):

Oliver Graupner ◽

Jessica Koch ◽

Christian Enzensberger ◽

Malena Götte ◽

Aline Wolter ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Arch ◽

Blood Group ◽

Oxygen Delivery ◽

Congenital Heart ◽

Normative Values ◽

Low Oxygen ◽

The Brain ◽

Group 1

Abstract Purpose Altered cerebral hemodynamics are involved in changes in head biometry in fetuses with congenital heart disease (CHD). We compared head growth in different CHD groups with published normative values and investigated whether CHD groups differ from each other in terms of head circumference (HC) development over gestational age (GA). Materials and Methods Retrospective cohort study consisting of 248 CHD fetuses. Subgroups were generated according to the expected ascending aorta oxygen saturation: Low placental blood content (BC) and therefore low oxygen delivery to the brain (group 1: n = 108), intermediate placental and systemic BC due to intracardiac mixing of blood (group 2: n = 103), high placental BC (group 3: n = 13) and low placental BC and low oxygen delivery to the brain without mixing of blood (group 4: n = 24). Furthermore, group 1 was divided into antegrade (n = 34) and retrograde (n = 74) flow through the aortic arch. Comparisons were made at a GA of 22, 30 and 38 weeks. Results Estimated values of zHC (z-score transformed) were not significantly different between the four CHD groups at the three time points in gestation (all p > 0.05). Within group 1 fetuses with retrograde aortic arch flow showed a significant negative association between HC and GA compared to reference values (b = –0.054, p < 0.001) and had significantly lower zHC values at 38 weeks (–0.836) compared to fetuses with antegrade flow (0.366, p = 0.009). Conclusion Our data do not confirm that CHD fetuses in general have a significantly smaller HC. HC becomes smaller throughout gestation depending on the direction of aortic arch flow.

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Congenital heart disease and aortic arch variants associated with mutation in PHOX2B

Genetics in Medicine ◽

10.1038/gim.2018.34 ◽

2018 ◽

Vol 20 (12) ◽

pp. 1538-1543 ◽

Cited By ~ 4

Author(s):

Rachel C Lombardo ◽

Aleksey Porollo ◽

James F Cnota ◽

Robert J Hopkin

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Arch ◽

Congenital Heart

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Isolated Interrupted Aortic Arch- A Complex Congenital heart disease

Cardiovascular Journal ◽

10.3329/cardio.v4i1.9400 ◽

1970 ◽

Vol 4 (1) ◽

pp. 102-104

Author(s):

A Shariar ◽

MA Huq ◽

NU Zakia ◽

M Salim ◽

SA Islam

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Arch ◽

Congenital Heart ◽

Septal Defect ◽

Interrupted Aortic Arch ◽

Cardiac Anomaly ◽

Complex Congenital Heart Disease ◽

Type B ◽

Left Carotid Artery

Interrupted Aortic Arch (lAA) is the absence or discontinuation of a portion of the aortic arch. There are three types of Interrupted Aortic Arch,and they are classified according to the site of the interruption. lsolated IAA appears commonly in type B lAA,where the interruption occurs between the left carotid artery and the left subclavian artery.In such case there is no associated cardiac anomaly and the patient may not exhibit lethal form of presentation unless there is duct dependent circulation or ventricular septal defect. lsolated interrupted arch is relatively rare congenital anomaly and very few cases were reported in literature so far. Keywords: lnterrupted aortic arch; Complex congenital heart disease. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9400 Cardiovasc. J. 2011; 4(1): 102-104

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Reconstruction of the aortic arch in an adolescent female with complex congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951100002122 ◽

1994 ◽

Vol 4 (2) ◽

pp. 164-167

Author(s):

Rajiv Verma ◽

Delores Danilowicz ◽

Stephen Colvin

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Arch ◽

Congenital Heart ◽

Complex Congenital Heart Disease ◽

Adolescent Female ◽

Ventricular Septal Defects ◽

Postoperative Course ◽

Septal Defects ◽

Complete Repair

AbstractCoarctations of the aortic arch are rare, and when found, they are often associated with other complex congenital heart disease. An adolescent female with multiple coarctations of the aortic arch and ventricular septal defects underwent complete repair, entailing replacement of the aortic arch with a homograft and closure of the ventricular septal defects. The postoperative course was complicated by a tear in the homograft, possibly related to sepsis. After its resolution, her hemodynamic results remain excellent.

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