ArticleThe Journal of thoracic and cardiovascular surgery2010
Larger aortic reconstruction corresponds to diminished left pulmonary artery size in patients with single-ventricle physiology.
Article in The Journal of thoracic and cardiovascular surgery, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 22 citations in OpenAlex.
- Impact of Initial Shunt Type on Echocardiographic Indices in Children After Single Right Ventricle Palliations.Circulation. Cardiovascular imaging · 2019Trial
- Linking shape and clinical outcomes: Statistical shape model of Bidirectional Glenn connection in congenital single ventricle patients.PLOS digital health · 2026Article
- Aortic growth after arch reconstruction with patch augmentation: a 2-decade experience.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Validation of a laser projection platform for the preparation of surgical patches used in paediatric cardiac surgery.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Statistical Shape Modeling for Cavopulmonary Assist Device Development: Variability of Vascular Graft Geometry and Implications for Hemodynamics.Journal of medical devices · 2017Article
- Three-dimensional rotational angiography in the assessment of vascular and airway compression in children after a cavopulmonary anastomosis.Pediatric cardiology · 2015Article
- Simulating hemodynamics of the Fontan Y-graft based on patient-specific in vivo connections.The Journal of thoracic and cardiovascular surgery · 2013Article
- Techniques for transcatheter recanalization of completely occluded vessels and pathways in patients with congenital heart disease.Annals of pediatric cardiology · 2010Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPulmonary artery size is a crucial determinant of hemodynamic energy loss in total cavopulmonary connections. We investigated the effect of aortic arch reconstruction on left pulmonary artery size based on their anatomic proximity.
methodsThirty-two patients undergoing the Fontan operation, 16 with hypoplastic left heart syndrome and 16 with non-hypoplastic left heart syndrome, were selected from the multicenter Fontan magnetic resonance imaging database at the Georgia Institute of Technology. The 16 datasets were consecutive with full anatomic reconstructions of the total cavopulmonary connection and aortic arch with no artifacts. The size of the aorta along the transverse arch and left pulmonary artery size in the region below the aortic arch was quantified by using a previously validated skeletonization technique.
resultsThe transverse aortic and left pulmonary artery measurements (median, maximum, and minimum, respectively) for non-hypoplastic left heart syndrome were 2.2, 3.1, and 1.5 cm/m and 1.2, 1.6, and 0.2 cm/m, respectively, compared with 2.5, 4.1, and 2.0 cm/m and 0.9, 1.5, and 0.4 cm/m for patients with hypoplastic left heart syndrome. Thus the transverse aortic diameter of patients with hypoplastic left heart syndrome was, on average, 24% greater than that for patients with non-hypoplastic left heart syndrome (P < .05), whereas the left pulmonary artery diameter of patients with hypoplastic left heart syndrome was smaller than that of patients with non-hypoplastic left heart syndrome (P < .05). Regression analysis showed a significant negative correlation (P < .05) between aortic and left pulmonary artery diameters in both the hypoplastic left heart syndrome and non-hypoplastic left heart syndrome groups. However, when the study population was regrouped into reconstructed aorta and nonreconstructed aorta groups, the negative correlation was only significant for patients with reconstructed aortas, regardless of ventricular pathology (P < .02).
conclusionsStage 1 aortic reconstruction procedures that result in a large aorta limit left pulmonary artery size in patients undergoing the Fontan operation.
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