caa a22 4500 445826177 CHVBK 20180317145259.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00246-010-9840-4 doi (NATIONALLICENCE)springer-10.1007/s00246-010-9840-4 Pathology of the Aortic Arch in Hypoplastic Left Heart Syndrome: Surgical Implications [Elektronische Daten] [Shanthi Sivanandam, Shannon Mackey-Bojack, James Moller] Aortic arch reconstruction plays an important role in the success of the Norwood procedure (NP) for hypoplastic left heart syndrome (HLHS). This study investigated the cardiac specimens to determine the etiology of distal aortic arch obstruction after the NP for HLHS and to locate coarctation of the aorta in HLHS untreated by surgery. This study examined 17 cardiac specimens: 9 that had NP and 8 not treated by surgery. The findings after NP showed frequent failure to resect the coarctation segment completely and failure to extend the augmentation patch into the descending aorta. Five (62.5%) of the eight hearts not treated by surgery had significant periductal coarctation of the aorta. After NP for nine patients, three (33%) had residual coarctation of the aorta. To minimize the risk of recurrent or persistent aortic arch obstruction after NP and to improve the long- and short-term outcome, the ductal tissue and the coarctation segment encircling the aortic lumen should be resected. The distal wall incision should be extended at least 5mm beyond the distal aspect of the ductal tissue. These steps could avoid major aortic arch obstruction, promote growth of the native aortic tissue, and avoid ventricular dysfunction. Springer Science+Business Media, LLC, 2010 Aortic arch obstruction nationallicence Aortic arch reconstruction nationallicence Coarctation segment nationallicence Hypoplastic left heart syndrome nationallicence Norwood procedure nationallicence Sivanandam Shanthi Department of Pediatrics, University of Minnesota, 420 Delaware St, SE MMC 94, 55455, Minneapolis, MN, USA aut Mackey-Bojack Shannon Jesse E. Edwards Registry of Cardiovascular Disease, University of Minnesota, 420 Delaware St, SE MMC 94, 55455, Minneapolis, MN, USA aut Moller James Department of Pediatrics, University of Minnesota, 420 Delaware St, SE MMC 94, 55455, Minneapolis, MN, USA aut Pediatric Cardiology Springer-Verlag 32/2(2011-02-01), 189-192 0172-0643 32:2<189 2011 32 246 https://doi.org/10.1007/s00246-010-9840-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-010-9840-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sivanandam Shanthi Department of Pediatrics, University of Minnesota, 420 Delaware St, SE MMC 94, 55455, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Mackey-Bojack Shannon Jesse E. Edwards Registry of Cardiovascular Disease, University of Minnesota, 420 Delaware St, SE MMC 94, 55455, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Moller James Department of Pediatrics, University of Minnesota, 420 Delaware St, SE MMC 94, 55455, Minneapolis, MN, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/2(2011-02-01), 189-192 0172-0643 32:2<189 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer