Evidence map›Paper›PMID 38754122›Full record

ArticleInterdisciplinary cardiovascular and thoracic surgery2024

Morphology of the native ascending aorta after the Norwood procedure for aortic atresia: impact on survival and right ventricular dysfunction.

Thibault Schaeffer, Paul Philipp Heinisch, Helena Staehler, Stanimir Georgiev, Christoph Röhlig, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono

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Article in Interdisciplinary cardiovascular and thoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Thibault SchaefferDepartment of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0001-6842-2988
Paul Philipp HeinischDepartment of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0003-2606-0557
Helena StaehlerDepartment of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0003-4034-3967
Stanimir GeorgievDepartment of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0002-6239-8160
Christoph RöhligDepartment of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technische Universität München, Munich, Germany.
Alfred HagerDepartment of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0002-2481-2017
Peter EwertDepartment of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0003-0253-1190
Jürgen HörerDepartment of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.
Masamichi OnoDepartment of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.ORCID 0000-0001-5699-6394

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOur goal was to evaluate the impact of variable morphology of the native ascending aorta after the Norwood I procedure in patients with hypoplastic left heart syndrome/aortic atresia on long-term survival and systemic right ventricular dysfunction.

methodsOf 151 survivors of the Norwood procedure for hypoplastic left heart syndrome/aortic atresia at our institution between January 2001 and December 2020, we included patients with available and measurable aortograms prior to stage II palliation. The diameter of the native ascending aorta, the length of the native ascending aorta and the angle between the native ascending aorta and the proximal pulmonary artery were measured. We investigated the impact of these morphologic parameters on mortality and on right ventricular dysfunction (defined as at least moderate).

resultsAngiograms were available for 78 patients. The median diameter of the native ascending aorta was 3.2 mm (2.6-3.7), the median length of the native ascending aorta was 15.4 mm (13.3-17.9) and the median angle between the native ascending aorta and the proximal pulmonary artery was 44° (35°-51°). During the median follow-up of 6.5 years, 8 (10%) patients died and systemic right ventricular dysfunction occurred in 19 patients (24%). No significant association between aortic morphology and mortality could be detected. Right ventricular function was negatively affected by a larger angle between the native ascending aorta and the proximal pulmonary artery [odds ratio 1.07 (1.01-1.14), P = 0.02].

conclusionsIn survivors of the Norwood procedure for hypoplastic left heart syndrome/aortic atresia with available angiograms, no significant association between native aortic morphology and mortality could be demonstrated after stage II palliation, within the scope of this limited study. A larger anastomosis angle between the native ascending aorta and the proximal pulmonary artery emerged as a risk factor for right ventricular dysfunction.

Indexed as

Hypoplastic left heart syndromeNorwood procedureRight ventricular dysfunction

Identifiers

PMID38754122
PMCPMC11272171

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