Neo-aortic posterior sinus of Valsalva reduction and closed coronary artery transfer as a method to approach aortopulmonary mismatch in transposition of great arteries
| Autor: | Vincenzo Poli, Alice Brambilla, Cecilia Viacava, Vitali Pak, Antonio Ravaglioli, Luigi Arcieri, Duccio Federici, Bruno Murzi |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic arch Male Reoperation medicine.medical_specialty medicine.medical_treatment Transposition of Great Vessels Interquartile range medicine.artery Internal medicine Ascending aorta medicine Humans Sinus (anatomy) Reduction (orthopedic surgery) business.industry Infant Sinus of Valsalva Coronary Vessels Arterial Switch Operation medicine.anatomical_structure Great arteries cardiovascular system Hypoplastic aortic arch Cardiology Surgery Cardiology and Cardiovascular Medicine business Artery Follow-Up Studies |
| Zdroj: | Journal of cardiac surgeryREFERENCES. 36(10) |
| ISSN: | 1540-8191 |
| Popis: | OBJECTIVE In transposition of great arteries (TGA), aortopulmonary mismatch (APM) can determine postoperative neo-aortic insufficiency after arterial switch operation (ASO). The distortion of sinu-tubular junction may be the geometric mechanism responsible. We developed a strategy able to reduce the mismatch at the timing of ASO, and in this study, we aimed to describe our indications and results. METHODS Preoperative root circumferences at the level of the mid-portion of sinus of Valsalva and ascending aorta circumference were used to define APM. Indication to surgery was a neo-aortic root (NAR) to ascending aorta ratio ≥ 1.4. Along with standard ASO, posterior neo-aortic sinus inverted conal resection and punch technique for coronary reimplantation was used in all patients to re-establish the more geometric ratio possible between the two components. Hypoplastic aortic arch (HAA) and aortic coarctation (CA) were managed by aortic arch enlargement with an autologous pericardial patch. RESULTS Twenty patients (20 male), 19 with diagnoses TGA (17 with ventricular septal defect, 85%) and 1 with Taussig-Bing anomaly underwent ASO. HAA was present in three (15%) and CA in two (10%). The mean preoperative neo-aortic to ascending aorta ratio was 1.8 versus 1.1 postoperatively (p |
| Databáze: | OpenAIRE |
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