Medical and surgical advances have allowed single-stage total repair in neonates born
with complex congenital heart anomalies and aortic arch obstruction. Nonetheless,
total repair might be too complex or high risk in certain neonates with demographic,
clinical or morphologic risk factors. Alternative management strategies might offer
these neonates better outcomes with superior anatomic repair, shorter hospitalization,
reduced morbidity, and improved survival. Alternative initial surgical strategies
might include aortic arch repair and pulmonary artery band with or without cardiopulmonary
bypass, extracardiac repair only and pulmonary artery band, Norwood operation, and
hybrid first-stage palliation; all deferring complex biventricular intra-cardiac repair
to later stage. The strategy choice should be personalized to each patient, taking
into consideration the morphologic and clinical state, and the existent goals of care.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery AnnualAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Outcomes in patients with interrupted aortic arch and ventricular septal defect. A multiinstitutional study. Congenital Heart Surgeons Society.J Thorac Cardiovasc Surg. 1994; 107: 1099-1109
- Associated factors and trends in outcomes of interrupted aortic arch.Ann Thorac Surg. 2004; 78: 1696-1702https://doi.org/10.1016/j.athoracsur.2004.05.035
- Selective management strategy of interrupted aortic arch mitigates left ventricular outflow tract obstruction risk.J Thorac Cardiovasc Surg. 2016; 151: 412-420https://doi.org/10.1016/j.jtcvs.2015.09.060
- Taussig-Bing anomaly: arterial switch versus Kawashima intraventricular repair.Ann Thorac Surg. 1996; 61: 1330-1338https://doi.org/10.1016/0003-4975(96)00079-3
- Improved results with single-stage total correction of Taussig-Bing anomaly.Eur J Cardiothorac Surg. 2008; 33: 244-250https://doi.org/10.1016/j.ejcts.2007.11.017
- Arterial Switch Operation in Patients With Taussig-Bing Anomaly and Aortic Arch Obstruction.Ann Thorac Surg. 2022; 114: 834-840https://doi.org/10.1016/j.athoracsur.2021.05.082
- Late outcomes after arterial switch operation for Taussig-Bing anomaly.J Thorac Cardiovasc Surg. 2015; 149: 1124-1130https://doi.org/10.1016/j.jtcvs.2014.10.082
- Gestational age at birth and outcomes after neonatal cardiac surgery: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.Circulation. 2014; 129: 2511-2517https://doi.org/10.1161/CIRCULATIONAHA.113.005864
- Low-weight infants are at increased mortality risk after palliative or corrective cardiac surgery.J Thorac Cardiovasc Surg. 2014; 148: 2508-2514https://doi.org/10.1016/j.jtcvs.2014.07.047
- Cardiac surgery in infants with low birth weight is associated with increased mortality: analysis of the Society of Thoracic Surgeons Congenital Heart Database.J Thorac Cardiovasc Surg. 2008; 135: 546-551https://doi.org/10.1016/j.jtcvs.2007.09.068
- the effect of noncardiac and genetic abnormalities on outcomes following neonatal congenital heart surgery.Semin Thorac Cardiovasc Surg. 2016; 28: 105-114https://doi.org/10.1053/j.semtcvs.2015.10.016
- Low birth weight and very low birth weight neonates with congenital heart disease: timing of surgery, reasons for delaying or not delaying surgery.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2013; 16: 13-20https://doi.org/10.1053/j.pcsu.2013.01.004
- Intermediate results following complex biventricular repair of left ventricular outflow tract obstruction in neonates and infants.Eur J Cardiothorac Surg. 2010; 38: 431-438https://doi.org/10.1016/j.ejcts.2010.02.035
- How small is too small? decision-making and management of the small aortic root in the setting of interrupted aortic arch.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2019; 22: 21-26https://doi.org/10.1053/j.pcsu.2019.02.004
- The Yasui operation for patients with adequate-sized ventricles and ventricular septal defect associated with obstructions of the aortic arch and left ventricular outflow tract.Eur J Cardiothorac Surg. 2014; 45: e166-e172https://doi.org/10.1093/ejcts/ezt658
- Interrupted aortic arch: surgical decision making.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2005; : 92-102https://doi.org/10.1053/j.pcsu.2005.01.023
- Biventricular repair in interrupted aortic arch and ventricular septal defect with a small left ventricular outflow tract.Ann Thorac Surg. 2021; 111: 637-644https://doi.org/10.1016/j.athoracsur.2020.05.045
- Outcomes following aortic valve replacement in children with conotruncal anomalies.World J Pediatr Congenit Heart Surg. 2022; 13: 178-186https://doi.org/10.1177/21501351211072476
- Ross-konno for interrupted aortic arch: simplified arch reconstruction using swing-back technique.Ann Thorac Surg. 2018; 105: e91-e93https://doi.org/10.1016/j.athoracsur.2017.10.023
- Impact of patient characteristics and anatomy on results of norwood operation for hypoplastic left heart syndrome.Ann Thorac Surg. 2015; 100: 591-598https://doi.org/10.1016/j.athoracsur.2015.03.106
- Outcomes and short-term follow-up in complex ross operations in pediatric patients undergoing damus-kaye-stansel takedown.Semin Thorac Cardiovasc Surg. 2016; 28: 81-89https://doi.org/10.1053/j.semtcvs.2015.09.006
- Biventricular repair after the hybrid Norwood procedure.Eur J Cardiothorac Surg. 2019; 56: 110-116https://doi.org/10.1093/ejcts/ezz028
- Staged biventricular repair after hybrid procedure in high-risk neonates and infants.World J Pediatr Congenit Heart Surg. 2019; 10: 426-432https://doi.org/10.1177/2150135119845245
- Long-term results of biventricular repair after initial Giessen hybrid approach for hypoplastic left heart variants.J Thorac Cardiovasc Surg. 2015; 149: 1112-1120https://doi.org/10.1016/j.jtcvs.2014.09.028
- Hybrid palliation for interrupted aortic arch with small aortic valve.World J Pediatr Congenit Heart Surg. 2017; 8: 332-336https://doi.org/10.1177/2150135117690125
Article info
Publication history
Published online: February 02, 2023
Footnotes
Conflict of Interest: There is no potential conflict of interest.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
