AI Article Synopsis
- The study investigates the effectiveness of using porcine small intestinal submucosa (PSIS) as a patch material during Norwood palliation, focusing on rates of neoaortic arch reintervention and overall survival.
- A retrospective review of 44 patients revealed a low rate of reinterventions (11.4% related to the PSIS patch) and some unrelated surgeries, with a median follow-up of 387.5 days.
- The findings suggest that PSIS could be a suitable option for Norwood palliation, but further research with longer follow-up is needed to assess long-term outcomes.
Article Abstract
Background: Norwood palliation typically requires patch augmentation of the ascending aorta and aortic arch. Patients having undergone Norwood palliation are at risk of recurrent arch obstruction, the risk of which may be affected by the type of patch material used at the time of Norwood palliation. We sought to determine the freedom from neoaortic arch reintervention and overall survival in patients who underwent Norwood palliation utilizing porcine small intestinal submucosa (PSIS) as the patch material.
Methods: Retrospective chart review was performed to identify patients who underwent a Norwood operation utilizing PSIS material at our institution. Cardiac diagnosis, age at surgery, shunt type, need for reintervention, and outcome (survival, transplant, and death) were evaluated.
Results: Forty-four patients had PSIS material utilized for arch reconstruction at the time of Norwood palliation. There were only five neoaortic arch reinterventions in 4 patients (11.4%). An additional 10 reinterventions, unrelated to the PSIS patch, were performed, including five shunt revisions and five branch pulmonary artery interventions. There were 3 deaths, and 5 patients underwent transplantation. Median follow-up was 387.5 days (range, 4 to 1,513).
Conclusions: Freedom from neoaortic arch reintervention and survival after Norwood palliation with PSIS patch material is promising. The PSIS appears noninferior and may be an appropriate tissue choice for Norwood palliation. Studies with longer follow-up are needed to determine the rate of neoaortic reintervention over time.
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| http://dx.doi.org/10.1016/j.athoracsur.2018.06.033 | DOI Listing |
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