Presentation is loading. Please wait.

Presentation is loading. Please wait.

Aortic arch geometry after the Norwood procedure: The value of arch angle augmentation  Tomomi Hasegawa, MD, PhD, Yoshihiro Oshima, MD, PhD, Ayako Maruo,

Published byAnita Johansen Modified over 6 years ago

Similar presentations

Presentation on theme: "Aortic arch geometry after the Norwood procedure: The value of arch angle augmentation  Tomomi Hasegawa, MD, PhD, Yoshihiro Oshima, MD, PhD, Ayako Maruo,"— Presentation transcript:

1 Aortic arch geometry after the Norwood procedure: The value of arch angle augmentation 
Tomomi Hasegawa, MD, PhD, Yoshihiro Oshima, MD, PhD, Ayako Maruo, MD, PhD, Hironori Matsuhisa, MD, PhD, Akiko Tanaka, MD, PhD, Rei Noda, MD, Shunsuke Matsushima, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 150, Issue 2, Pages (August 2015) DOI: /j.jtcvs Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Diagram depicting the Norwood procedure. A, Augmentation of the aortic arch with GA-AP. The GA-AP is interposed between the PA and the dAo. B, Aortic arch reconstruction with right-ventricle-to-pulmonary-artery (RV-PA) shunt. Additional patch augmentation (*) for the anterior wall of the neoaorta is performed, if necessary. dAo, Descending aorta; GA-AP, glutaraldehyde-treated autologous pericardium; PA, pulmonary trunk; RV-PA, right-ventricle-to-pulmonary-artery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Measurement of the aortic arch geometry. A, Left lateral oblique computed tomography projection. a = arch angle (angulation between the 2 tangent lines from the highest point of the aortic arch to the centerline of the aortic arch); b = arch height (distance between the inferior margin of the aortic arch and the superior margin of the left main bronchus); X = minimal diameter of the aortic arch at the anastomotic site in the Norwood group or at the isthmus in the control group; Y = diameter of the dAo at the level of the diaphragm. The ratio of X to Y is calculated as “arch/dAo diameter ratio.” B, Axial computed tomography projection. aAo, Ascending aorta; LBr, left main bronchus; dAo, descending aorta. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Flow diagram that demonstrates (A) the groups and (B) the postoperative events. The solid line shows the flow diagram for patients who did not undergo bPAB. The broken line shows the flow diagram for patients who underwent bPAB. HLHS, Hypoplastic left heart syndrome and its variants; IAA/CoA, interrupted aortic arch and coarctation complex with left ventricular outflow tract obstruction; bPAB, bilateral pulmonary artery banding; AAA, arch angle augmentation group (red); NA, no arch angle augmentation group (blue); BDG, bidirectional Glenn; SV, single-ventricle physiology; BV, biventricular physiology; Br/PA, reintervention and reoperation for bronchomalacia or branch pulmonary artery stenosis; reCoA, reintervention and reoperation for recoarctation. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Freedom from reintervention/reoperation for (A) bronchomalacia and branch PA stenosis, and (B) recoarctation. AAA, Arch angle augmentation group; NA, no arch angle augmentation group. The dotted line represent the 95% confidence intervals. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Typical 3-dimensional multidetector-row computed tomographic angiography image in each group: (A) control patient; (B) Norwood patient, arch angle augmentation; and (C) Norwood patient, no arch angle augmentation. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

7 Three-dimensional MDCTA image in a patient who underwent Norwood procedure with arch angle augmentation The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Download ppt "Aortic arch geometry after the Norwood procedure: The value of arch angle augmentation  Tomomi Hasegawa, MD, PhD, Yoshihiro Oshima, MD, PhD, Ayako Maruo,"

Similar presentations

Orlando Petrucci, MD, PhD, Philip R. Khoury, MS, Peter B

Orlando Petrucci, MD, PhD, Philip R. Khoury, MS, Peter B
Marcello Gomide, MD, Barbara Furci, MD, Branko Mimic, MD, Kate L

Marcello Gomide, MD, Barbara Furci, MD, Branko Mimic, MD, Kate L
Aortic valve replacement in low-flow, low-gradient aortic stenosis: Left ventricular ejection fraction matters  Victor Dayan, MD, PhD, Philippe Pibarot,

Aortic valve replacement in low-flow, low-gradient aortic stenosis: Left ventricular ejection fraction matters  Victor Dayan, MD, PhD, Philippe Pibarot,
A reinforced right-ventricle-to-pulmonary-artery conduit for the stage-1 Norwood procedure improves pulmonary artery growth  James R. Bentham, MD, PhD,

A reinforced right-ventricle-to-pulmonary-artery conduit for the stage-1 Norwood procedure improves pulmonary artery growth  James R. Bentham, MD, PhD,
The hybrid procedure for hypoplastic left heart syndrome: A procedure still looking for its place  Carlos M. Mery, MD, MPH  The Journal of Thoracic and.

The hybrid procedure for hypoplastic left heart syndrome: A procedure still looking for its place  Carlos M. Mery, MD, MPH  The Journal of Thoracic and.
Lecompte operation: Is it still a viable option for truncus arteriosus?  Chun Soo Park, MD, Won-Kyoung Jhang, MD, Jae-Kon Ko, MD, Young-Hwue Kim, MD, Tae-Jin.

Lecompte operation: Is it still a viable option for truncus arteriosus?  Chun Soo Park, MD, Won-Kyoung Jhang, MD, Jae-Kon Ko, MD, Young-Hwue Kim, MD, Tae-Jin.
Influence of surgical arch reconstruction methods on single ventricle workload in the Norwood procedure  Keiichi Itatani, MD, Kagami Miyaji, MD, PhD,

Influence of surgical arch reconstruction methods on single ventricle workload in the Norwood procedure  Keiichi Itatani, MD, Kagami Miyaji, MD, PhD,
Minimally invasive left ventricular assist device implantation with outflow graft anastomosis to the innominate artery  Jasmin S. Hanke, MD, Sebastian.

Minimally invasive left ventricular assist device implantation with outflow graft anastomosis to the innominate artery  Jasmin S. Hanke, MD, Sebastian.
Aortic arch reconstruction using a Kommerell diverticulum for hypoplastic left heart syndrome with a right aortic arch  Shunsuke Matsushima, MD, Yoshihiro.

Aortic arch reconstruction using a Kommerell diverticulum for hypoplastic left heart syndrome with a right aortic arch  Shunsuke Matsushima, MD, Yoshihiro.
Orlando Petrucci, MD, PhD, Philip R. Khoury, MS, Peter B

Orlando Petrucci, MD, PhD, Philip R. Khoury, MS, Peter B
Christopher W. Baird, MD, Joseph M. Forbess, MD 

Christopher W. Baird, MD, Joseph M. Forbess, MD 
Pirooz Eghtesady, MD, PhD, Anoop Brar, PhD, Matthew Hall, PhD 

Pirooz Eghtesady, MD, PhD, Anoop Brar, PhD, Matthew Hall, PhD 
Surgical strategy for Kommerell's diverticulum: Total arch replacement

Surgical strategy for Kommerell's diverticulum: Total arch replacement
Marcello Gomide, MD, Barbara Furci, MD, Branko Mimic, MD, Kate L

Marcello Gomide, MD, Barbara Furci, MD, Branko Mimic, MD, Kate L
The practical clinical value of three-dimensional models of complex congenitally malformed hearts  Eugénie Riesenkampff, MD, Urte Rietdorf, MSc, Ivo Wolf,

The practical clinical value of three-dimensional models of complex congenitally malformed hearts  Eugénie Riesenkampff, MD, Urte Rietdorf, MSc, Ivo Wolf,
Aortic root translocation with atrial switch: Another surgical option for congenitally corrected transposition of the great arteries with isolated pulmonary.

Aortic root translocation with atrial switch: Another surgical option for congenitally corrected transposition of the great arteries with isolated pulmonary.
Ross procedure in the setting of anomalous aortic origin of a coronary artery  Amit Pawale, MD, Bobby Yanagawa, MD, PhD, Robin Varghese, MD, Paul Stelzer,

Ross procedure in the setting of anomalous aortic origin of a coronary artery  Amit Pawale, MD, Bobby Yanagawa, MD, PhD, Robin Varghese, MD, Paul Stelzer,
Pulmonary and aortic root translocation in the management of transposition of the great arteries with ventricular septal defect and left ventricular outflow.

Pulmonary and aortic root translocation in the management of transposition of the great arteries with ventricular septal defect and left ventricular outflow.
Valve-sparing procedure and Lecompte maneuver in patients with late aortic regurgitation and aortic aneurysm after the arterial switch operation  Yih-Sharng.

Valve-sparing procedure and Lecompte maneuver in patients with late aortic regurgitation and aortic aneurysm after the arterial switch operation  Yih-Sharng.
Dynamic computed tomography to determine cardiac output in patients with left ventricular assist devices  Subha V. Raman, MD, MSEE, Tam Tran, BS, Orlando.

Dynamic computed tomography to determine cardiac output in patients with left ventricular assist devices  Subha V. Raman, MD, MSEE, Tam Tran, BS, Orlando.

Similar presentations

Ads by Google