Skip to main content
Top
Published in: General Thoracic and Cardiovascular Surgery 7/2021

01-07-2021 | Case Report

Ascending aortic extension to enlarge the retroaortic space in children after the Norwood procedure

Authors: Hideki Tatewaki, Toshihide Nakano, Yusuke Ando, Gen Shinohara, Shuhei Fujita, Dai Araki, Takuya Nishijima, Hiroki Sakai, Hideaki Kado

Published in: General Thoracic and Cardiovascular Surgery | Issue 7/2021

Login to get access

Abstract

Left pulmonary artery stenosis is a well-recognized complication following the Norwood procedure. We herein report two cases in which ascending aortic extension was performed to enlarge the retroaortic space in children with left pulmonary artery stenosis after the Norwood procedure. We used graft interposition in the ascending aorta to increase the retroaortic apace and concomitantly performed extended left pulmonary artery reconstruction. This procedure obtains a more balanced distribution of the pulmonary blood flow, which is crucial to achieve good Fontan circulation.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bichell DP, Lamberti JJ, Pelletier GJ, Hoecker C, Cocalis MW, Ing FF, Jensen RA. Late left pulmonary artery stenosis after the Norwood procedure is prevented by a modification in shunt construction. Ann Thorac Surg. 2005;79:1656–60.CrossRef Bichell DP, Lamberti JJ, Pelletier GJ, Hoecker C, Cocalis MW, Ing FF, Jensen RA. Late left pulmonary artery stenosis after the Norwood procedure is prevented by a modification in shunt construction. Ann Thorac Surg. 2005;79:1656–60.CrossRef
2.
go back to reference Alsaied T, Sleeper LA, Masci M, Ghelani SJ, Azcue N, Geva T, Powell AJ, Rathod RH. Maldistribution of pulmonary blood flow in patients after the Fontan operation is associated with worse exercise capacity. J Cardiovasc Magn Reson. 2018;20:85.CrossRef Alsaied T, Sleeper LA, Masci M, Ghelani SJ, Azcue N, Geva T, Powell AJ, Rathod RH. Maldistribution of pulmonary blood flow in patients after the Fontan operation is associated with worse exercise capacity. J Cardiovasc Magn Reson. 2018;20:85.CrossRef
3.
go back to reference Plummer ST, Hornik CP, Baker H, Fleming GA, Foerster S, Ferguson ME, Glatz AC, Hirsch R, Jacobs JP, Lee KJ, Lewis AB, Li JS, Martin M, Porras D, Radtke WA, Rhodes JF, Vincent JA, Zampi JD, Hill KD. Maladaptive aortic properties after the Norwood procedure: an angiographic analysis of the pediatric heart network single ventricle reconstruction trial. J Thorac Cardiovasc Surg. 2016;152:471–9.CrossRef Plummer ST, Hornik CP, Baker H, Fleming GA, Foerster S, Ferguson ME, Glatz AC, Hirsch R, Jacobs JP, Lee KJ, Lewis AB, Li JS, Martin M, Porras D, Radtke WA, Rhodes JF, Vincent JA, Zampi JD, Hill KD. Maladaptive aortic properties after the Norwood procedure: an angiographic analysis of the pediatric heart network single ventricle reconstruction trial. J Thorac Cardiovasc Surg. 2016;152:471–9.CrossRef
4.
go back to reference Hasegawa T, Oshima Y, Maruo A, Matsuhisa H, Tanaka A, Noda R, Matsushima S. Aortic arch geometry after the Norwood procedure: the value of arch angle augmentation. J Thorac Cardiovasc Surg. 2015;150:358–66.CrossRef Hasegawa T, Oshima Y, Maruo A, Matsuhisa H, Tanaka A, Noda R, Matsushima S. Aortic arch geometry after the Norwood procedure: the value of arch angle augmentation. J Thorac Cardiovasc Surg. 2015;150:358–66.CrossRef
5.
go back to reference Itatani K, Miyaji K, Qian Y, Liu JL, Miyakoshi T, Murakami A, Ono M, Umezu M. Influence of surgical arch reconstruction methods on single ventricle workload in the Norwood procedure. J Thorac Cardiovasc Surg. 2012;144:130–8.CrossRef Itatani K, Miyaji K, Qian Y, Liu JL, Miyakoshi T, Murakami A, Ono M, Umezu M. Influence of surgical arch reconstruction methods on single ventricle workload in the Norwood procedure. J Thorac Cardiovasc Surg. 2012;144:130–8.CrossRef
6.
go back to reference Baker CJ, Wells WJ, Derby CA, Rizi S, Starnes VA. Ascending aortic extension for enlargement of the aortopulmonary space in children with pulmonary artery stenosis. Ann Thorac Surg. 2005;80:1647–51.CrossRef Baker CJ, Wells WJ, Derby CA, Rizi S, Starnes VA. Ascending aortic extension for enlargement of the aortopulmonary space in children with pulmonary artery stenosis. Ann Thorac Surg. 2005;80:1647–51.CrossRef
7.
go back to reference Menon A, Jones T, Barron D, Stumper O, Brawn W. Posterior reduction aortoplasty for left pulmonary artery compression after Norwood procedure. Ann Thorac Surg. 2011;91:1300–1.CrossRef Menon A, Jones T, Barron D, Stumper O, Brawn W. Posterior reduction aortoplasty for left pulmonary artery compression after Norwood procedure. Ann Thorac Surg. 2011;91:1300–1.CrossRef
8.
go back to reference Sakurai H, Mizutani S, Kato N, Sawaki S, Sakurai T, Sugiura J, Matsushima M. A novel ascending aortic extension and plication technique for narrowing the retroaortic space. J Thorac Cardiovasc Surg. 2006;132:695–6.CrossRef Sakurai H, Mizutani S, Kato N, Sawaki S, Sakurai T, Sugiura J, Matsushima M. A novel ascending aortic extension and plication technique for narrowing the retroaortic space. J Thorac Cardiovasc Surg. 2006;132:695–6.CrossRef
9.
go back to reference Asada S, Yamagishi M, Itatani K, Yaku H. Chimney reconstruction of the aortic arch in the Norwood procedure. J Thorac Cardiovasc Surg. 2017;154:e51–4.CrossRef Asada S, Yamagishi M, Itatani K, Yaku H. Chimney reconstruction of the aortic arch in the Norwood procedure. J Thorac Cardiovasc Surg. 2017;154:e51–4.CrossRef
Metadata
Title
Ascending aortic extension to enlarge the retroaortic space in children after the Norwood procedure
Authors
Hideki Tatewaki
Toshihide Nakano
Yusuke Ando
Gen Shinohara
Shuhei Fujita
Dai Araki
Takuya Nishijima
Hiroki Sakai
Hideaki Kado
Publication date
01-07-2021
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 7/2021
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-021-01618-0

Other articles of this Issue 7/2021

General Thoracic and Cardiovascular Surgery 7/2021 Go to the issue