Abstract |
This study aims to clarify the relation of development of aortopulmonary collateral arteries (APCs) with anatomical sub-types and the shunt types at Norwood procedure in patients with hypoplastic left heart syndrome (HLHS). A total of 140 patients with HLHS who completed 3 staged palliation between 2003 and 2019 were included. Incidence of APCs and corresponding interventions were examined using angiogram by cardiac catheterization, with respect to the anatomical sub-types and shunt types. Totally, APCs were observed in 87 (62%) of the patients; pre-stage II in 32 (23%), pre-stage III in 64 (46%), and after stage III in 40 (29%). The incidence of APCs before stage II was significantly higher in patients with aortic atresia/mitral atresia (AA/MA) compared with other sub-types (P = 0.022). Patients with right ventricle to pulmonary artery conduit (RVPAC) had a higher incidence of APCs originating from the descending aorta, compared with those with modified Blalock-Taussig shunt (20% vs 2%, P= 0.002). Interventions for APCs were performed in 58 (41%) patients; before stage II in 10 (7%), after stage II in 7 (5%), before stage III in 22 (16%), and after stage III in 32 (23%). Patients with AA/MA had more interventions before stage II (P= 0.019), and patients with aortic stenosis/ mitral stenosis (AS/MS) had a lower incidence of interventions after stage III (P= 0.047). More than half of the patients with HLHS developed APCs. Before stage II, patients with AA/MA sub-type had a higher incidence of APCs, and those with RVPAC had significantly more APCs from the descending aorta.
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Authors | Melvin Schmiel, Masamichi Ono, Helena Staehler, Stanimir Georgiev, Melchior Burri, Paul Philipp Heinisch, Martina Strbad, Peter Ewert, Alfred Hager, Jürgen Hörer |
Journal | Seminars in thoracic and cardiovascular surgery
(Semin Thorac Cardiovasc Surg)
2023 Winter
Vol. 35
Issue 4
Pg. 746-756
ISSN: 1532-9488 [Electronic] United States |
PMID | 36007868
(Publication Type: Journal Article)
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Copyright | Copyright © 2022 Elsevier Inc. All rights reserved. |
Topics |
- Humans
- Hypoplastic Left Heart Syndrome
(diagnostic imaging, surgery)
- Treatment Outcome
- Pulmonary Artery
(diagnostic imaging, surgery)
- Blalock-Taussig Procedure
- Norwood Procedures
(adverse effects)
- Heart Ventricles
(surgery)
- Retrospective Studies
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