Geometry of the Aortic Arch After Initial Hybrid or Norwood Palliation

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Presentation transcript:

Geometry of the Aortic Arch After Initial Hybrid or Norwood Palliation Christoph Haller, MD, Devin Chetan, MD, Arezou Saedi, MD, Rachel Parker, BScH, Glen S. Van Arsdell, MD, Christopher A. Caldarone, MD, Osami Honjo, MD, PhD The Annals of Thoracic Surgery Volume 102, Issue 6, Pages 2077-2086 (December 2016) DOI: 10.1016/j.athoracsur.2016.05.008 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Aortic angiograms during palliation with schemes delineating points of measurements. (A) After Norwood operation before stage II procedure. (B) After hybrid procedure before comprehensive stage II procedure. (C) Before Fontan completion. (AA = ascending aorta; DA = descending aorta; IA = isthmus of the aorta; TA = transverse arch.) The Annals of Thoracic Surgery 2016 102, 2077-2086DOI: (10.1016/j.athoracsur.2016.05.008) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Flow diagram of patients at different stages of palliation. (Angio = angiography; Cath = cardiac catheterization; OR = operating room.) The Annals of Thoracic Surgery 2016 102, 2077-2086DOI: (10.1016/j.athoracsur.2016.05.008) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Pre–stage II or pre–comprehensive stage II and pre–stage III descending aorta z-scores. (HP = hybrid procedure group; NP = Norwood procedure group; P1 = time of angiogram before stage II or comprehensive stage II procedure; P2 = time of angiogram before Fontan completion.) The Annals of Thoracic Surgery 2016 102, 2077-2086DOI: (10.1016/j.athoracsur.2016.05.008) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Aortic diameters at respective points of measurement before Fontan completion. (A) Ascending aorta. (B) Transverse arch. (C) Aortic isthmus. (D) Descending aorta. (BSA = body surface area; HP = hybrid procedure group; Norm = mean aortic dimension for respective body surface area; NP = Norwood procedure group.) The Annals of Thoracic Surgery 2016 102, 2077-2086DOI: (10.1016/j.athoracsur.2016.05.008) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Z-scores at the time of angiogram before Fontan completion (P2). (A) Comparison of z-scores between Norwood and hybrid palliation procedures. (B) Comparison of z-scores in hybrid palliation with or without stent retention. (AA = ascending aorta; DA = descending aorta; HP = hybrid procedure group; IA = isthmus of the aorta; NP = Norwood procedure group; TA = transverse arch.) The Annals of Thoracic Surgery 2016 102, 2077-2086DOI: (10.1016/j.athoracsur.2016.05.008) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions