ArticleThe Journal of thoracic and cardiovascular surgery2016
Maladaptive aortic properties after the Norwood procedure: An angiographic analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial.
Article in The Journal of thoracic and cardiovascular surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 18 citations in OpenAlex.
- Dynamic Evaluation of Vascular Remodeling and Aneurysm Progression Using Blood-Pool Contrast-Enhanced In Vivo Micro-CT in a Rodent Model.Journal of cardiovascular translational research · 2026Article
- Is There a Unified Etiology of Hypoplastic Left Heart Syndrome? Evaluating Genetic, Structural, and Hemodynamic Models of Disease Initiation.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Review
- Ascending aortic dilation and aortic regurgitation - a neglected problem among single-ventricle patients after Fontan palliation.Cardiology journal · 2026Article
- Principal component analysis identified neo-aortic diameter variations post Norwood surgery associated with the single ventricle performance and flow quality.The international journal of cardiovascular imaging · 2024Article
- Hemodynamic inefficiencies during stress hold key for comprehensive assessment after Fontan operation.JTCVS techniques · 2024Article
- Gradual caliber transition of the neoaortic arch after the Norwood procedure can prevent neoaortic dilation and right ventricular deterioration.JTCVS open · 2022Article
- Ascending aortic extension to enlarge the retroaortic space in children after the Norwood procedure.General thoracic and cardiovascular surgery · 2021Article
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Authors and funding
19 authors at 15 institutions in 3 countries.
Funding
Abstract
objectivesAortic arch reconstruction in children with single ventricle lesions may predispose to circulatory inefficiency and maladaptive physiology leading to increased myocardial workload. We sought to describe neoaortic anatomy and physiology, risk factors for abnormalities, and impact on right ventricular function in patients with single right ventricle lesions after arch reconstruction.
methodsPrestage II aortic angiograms from the Pediatric Heart Network Single Ventricle Reconstruction trial were analyzed to define arch geometry (Romanesque [normal], crenel [elongated], or gothic [angular]), indexed neoaortic dimensions, and distensibility. Comparisons were made with 50 single-ventricle controls without prior arch reconstruction. Factors associated with ascending neoaortic dilation, reduced distensibility, and decreased ventricular function on the 14-month echocardiogram were evaluated using univariate and multivariable logistic regression.
resultsInterpretable angiograms were available for 326 of 389 subjects (84%). Compared with controls, study subjects more often demonstrated abnormal arch geometry (67% vs 22%, P < .01) and had increased ascending neoaortic dilation (Z score 3.8 ± 2.2 vs 2.6 ± 2.0, P < .01) and reduced distensibility index (2.2 ± 1.9 vs 8.0 ± 3.8, P < .01). Adjusted odds of neoaortic dilation were increased in subjects with gothic arch geometry (odds ratio [OR], 3.2 vs crenel geometry, P < .01) and a right ventricle-pulmonary artery shunt (OR, 3.4 vs Blalock-Taussig shunt, P < .01) but were decreased in subjects with aortic atresia (OR, 0.7 vs stenosis, P < .01) and those with recoarctation (OR, 0.3 vs no recoarctation, P = .04). No demographic, anatomic, or surgical factors predicted reduced distensibility. Neither dilation nor distensibility predicted reduced right ventricular function.
conclusionsAfter Norwood surgery, the reconstructed neoaorta demonstrates abnormal anatomy and physiology. Further study is needed to evaluate the longer-term impact of these features.
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