The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients
Objectives: Aortic arch abnormalities are frequently observed in neonates and may be associated with other congenital cardiac anomalies. Various surgical approaches exist for the repair of these abnormalities. This study aimed to review the outcomes of aortic arch surgery in neonates and infants. M...
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2025-06-01
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| Series: | Kardiyovasküler Tıp E Dergisi/E Journal of Cardiovascular Medicine |
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| Online Access: | https://www.jucvm.com/articles/the-role-of-patch-repair-in-aortic-arch-reconstruction-enhancing-outcomes-and-preserving-growth-potential-in-pediatric-patients/doi/jucvm.galenos.2025.2025-5-134 |
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| author | Serkan Seçici Seyyit Bahaettin Öncü |
| author_facet | Serkan Seçici Seyyit Bahaettin Öncü |
| author_sort | Serkan Seçici |
| collection | DOAJ |
| description | Objectives: Aortic arch abnormalities are frequently observed in neonates and may be associated with other congenital cardiac anomalies. Various surgical approaches exist for the repair of these abnormalities. This study aimed to review the outcomes of aortic arch surgery in neonates and infants.
Materials and Methods: We retrospectively analyzed patients who underwent aortic arch reconstruction with or without intracardiac anomalies between 2017 and 2022. The subjects were categorized into two groups based on the arch reconstruction technique employed: group 1 underwent patch aortoplasty via sternotomy, whereas group 2 underwent arch reconstruction without a patch via thoracotomy. Demographic information, morbidity rates, and mortality statistics were extracted from the departmental database for the analysis.
Results: This study enrolled 37 patients (25 males and 12 females). Twenty-nine patients were assigned to group 1, while eight patients were allocated to group 2. No significant differences were observed in the preoperative variables between the two groups. The overall median age and weight were 11 days (range: 2-270) and 3.1 kg (range: 1.4-5.6), respectively. Nine patients had a weight <2.5 kg. Twenty-eight patients underwent concomitant cardiac procedures. The 30-day mortality rate was 10.8% (n=4), with all deceased patients belonging to STAT Mortality Category 4 (n=31). No mortality was observed in the patients with isolated hypoplastic aortic arch or concomitant ventricular septal defect repair. At a median follow-up of 27 months, three patients in group 2 developed restenosis and underwent surgical correction. In group 1, restenosis was observed in only one patient, who was treated with balloon angioplasty. The incidence of recurrent arch obstruction was significantly higher in group 2 (p=0.02).
Conclusion: Aortic arch repair with patch through sternotomy represents a safe and efficacious approach, offering potential for intervention in intracardiac anomalies. The implementation of a patch facilitates tension-free anastomosis and optimal arch geometry, while demonstrating an acceptable rate of restenosis. |
| format | Article |
| id | doaj-art-4d656a64a01e47cf950261f5da3e7b3d |
| institution | Kabale University |
| issn | 2147-1924 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Kardiyovasküler Tıp E Dergisi/E Journal of Cardiovascular Medicine |
| spelling | doaj-art-4d656a64a01e47cf950261f5da3e7b3d2025-08-20T03:45:02ZengGalenos YayineviKardiyovasküler Tıp E Dergisi/E Journal of Cardiovascular Medicine2147-19242025-06-01132919810.32596/jucvm.galenos.2025.2025-5-134The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric PatientsSerkan Seçici0https://orcid.org/0000-0003-3988-8169Seyyit Bahaettin Öncü1https://orcid.org/0000-0002-6101-8031Medicana Bursa Hospital, Clinic of Pediatric Cardiovascular Surgery, Bursa, TürkiyeMedicana Bursa Hospital, Clinic of Pediatric Cardiology, Bursa, TürkiyeObjectives: Aortic arch abnormalities are frequently observed in neonates and may be associated with other congenital cardiac anomalies. Various surgical approaches exist for the repair of these abnormalities. This study aimed to review the outcomes of aortic arch surgery in neonates and infants. Materials and Methods: We retrospectively analyzed patients who underwent aortic arch reconstruction with or without intracardiac anomalies between 2017 and 2022. The subjects were categorized into two groups based on the arch reconstruction technique employed: group 1 underwent patch aortoplasty via sternotomy, whereas group 2 underwent arch reconstruction without a patch via thoracotomy. Demographic information, morbidity rates, and mortality statistics were extracted from the departmental database for the analysis. Results: This study enrolled 37 patients (25 males and 12 females). Twenty-nine patients were assigned to group 1, while eight patients were allocated to group 2. No significant differences were observed in the preoperative variables between the two groups. The overall median age and weight were 11 days (range: 2-270) and 3.1 kg (range: 1.4-5.6), respectively. Nine patients had a weight <2.5 kg. Twenty-eight patients underwent concomitant cardiac procedures. The 30-day mortality rate was 10.8% (n=4), with all deceased patients belonging to STAT Mortality Category 4 (n=31). No mortality was observed in the patients with isolated hypoplastic aortic arch or concomitant ventricular septal defect repair. At a median follow-up of 27 months, three patients in group 2 developed restenosis and underwent surgical correction. In group 1, restenosis was observed in only one patient, who was treated with balloon angioplasty. The incidence of recurrent arch obstruction was significantly higher in group 2 (p=0.02). Conclusion: Aortic arch repair with patch through sternotomy represents a safe and efficacious approach, offering potential for intervention in intracardiac anomalies. The implementation of a patch facilitates tension-free anastomosis and optimal arch geometry, while demonstrating an acceptable rate of restenosis.https://www.jucvm.com/articles/the-role-of-patch-repair-in-aortic-arch-reconstruction-enhancing-outcomes-and-preserving-growth-potential-in-pediatric-patients/doi/jucvm.galenos.2025.2025-5-134aortacardiovascular surgerycongenital heart defects |
| spellingShingle | Serkan Seçici Seyyit Bahaettin Öncü The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients Kardiyovasküler Tıp E Dergisi/E Journal of Cardiovascular Medicine aorta cardiovascular surgery congenital heart defects |
| title | The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients |
| title_full | The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients |
| title_fullStr | The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients |
| title_full_unstemmed | The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients |
| title_short | The Role of Patch Repair in Aortic Arch Reconstruction: Enhancing Outcomes and Preserving Growth Potential in Pediatric Patients |
| title_sort | role of patch repair in aortic arch reconstruction enhancing outcomes and preserving growth potential in pediatric patients |
| topic | aorta cardiovascular surgery congenital heart defects |
| url | https://www.jucvm.com/articles/the-role-of-patch-repair-in-aortic-arch-reconstruction-enhancing-outcomes-and-preserving-growth-potential-in-pediatric-patients/doi/jucvm.galenos.2025.2025-5-134 |
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