Long-term results of aortic arch reconstruction with branch pulmonary artery homograft patches

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Long-term results of aortic arch reconstruction with branch pulmonary artery homograft patches. / Lewis, Michael J.; Johansson Ramgren, Jens; Hallbergson, Anna; Liuba, Petru; Sjöberg, Gunnar; Malm, Torsten.

I: Journal of Cardiac Surgery, Vol. 35, Nr. 4, 04.2020, s. 868-874.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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T1 - Long-term results of aortic arch reconstruction with branch pulmonary artery homograft patches

AU - Lewis, Michael J.

AU - Johansson Ramgren, Jens

AU - Hallbergson, Anna

AU - Liuba, Petru

AU - Sjöberg, Gunnar

AU - Malm, Torsten

PY - 2020/4

Y1 - 2020/4

N2 - Background: Homograft tissue is an important reconstructive material used in the surgical correction of a variety of congenital heart defects. The aim of this study is to evaluate the long-term outcome of pulmonary artery (PA) branch patches used in the reconstruction of the thoracic aorta in children. Methods: Retrospective review of 124 consecutive pediatric patients undergoing corrective surgery for their congenital heart defects between 2001 and 2016. Survival, reoperation, and reintervention data were collected, as well as imaging data to assess for presence of recoarctation, dilation, or aneurysm formation in the area of patch reconstruction. Results: Overall 15-year survival was 83.9% and 15-year freedom from reintervention in the area of patch reconstruction was 89.2%. Rates of mortality (0%), cardiac transplantation (0%), and reoperation (0.8%) attributable to the area of patch reconstruction were low. The frequency of catheter-based intervention in the area of patch reconstruction was 9.7%; such interventions were successful in all but one patient, who ultimately underwent successful surgical aortoplasty. Conclusions: Homograft patches harvested from PA branches are an effective reconstructive material used for reconstruction of the aorta in small children. Long-term results show no risk of aneurysm formation and low rates of stenosis formation.

AB - Background: Homograft tissue is an important reconstructive material used in the surgical correction of a variety of congenital heart defects. The aim of this study is to evaluate the long-term outcome of pulmonary artery (PA) branch patches used in the reconstruction of the thoracic aorta in children. Methods: Retrospective review of 124 consecutive pediatric patients undergoing corrective surgery for their congenital heart defects between 2001 and 2016. Survival, reoperation, and reintervention data were collected, as well as imaging data to assess for presence of recoarctation, dilation, or aneurysm formation in the area of patch reconstruction. Results: Overall 15-year survival was 83.9% and 15-year freedom from reintervention in the area of patch reconstruction was 89.2%. Rates of mortality (0%), cardiac transplantation (0%), and reoperation (0.8%) attributable to the area of patch reconstruction were low. The frequency of catheter-based intervention in the area of patch reconstruction was 9.7%; such interventions were successful in all but one patient, who ultimately underwent successful surgical aortoplasty. Conclusions: Homograft patches harvested from PA branches are an effective reconstructive material used for reconstruction of the aorta in small children. Long-term results show no risk of aneurysm formation and low rates of stenosis formation.

KW - aorta and great vessels

KW - cardiovascular research

KW - congenital heart disease

KW - homograft

UR - http://www.scopus.com/inward/record.url?scp=85081332793&partnerID=8YFLogxK

U2 - 10.1111/jocs.14494

DO - 10.1111/jocs.14494

M3 - Article

C2 - 32160354

AN - SCOPUS:85081332793

VL - 35

SP - 868

EP - 874

JO - Journal of Cardiac Surgery

JF - Journal of Cardiac Surgery

SN - 1540-8191

IS - 4

ER -