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Neo-aortic insufficiency late after staged reconstruction for hypoplastic left heart syndrome: impact of differences in initial palliative procedures

  • Kentaro UmezuEmail author
  • Yorikazu Harada
  • Takahiko Sakamoto
  • Toru Okamura
  • Shizuya Shintomi
  • Kiyohiro Takigiku
  • Satoshi Yasukochi
Original Article
  • 32 Downloads

Abstract

The neo-aortic insufficiency in patients with hypoplastic left heart syndrome is an important sequela. We assessed the risks of the neo-aortic valve deterioration by the difference of initial palliations: Group I underwent primary Norwood (Nw) with systemic-to-pulmonary artery shunt (SPS), Group II underwent bilateral pulmonary artery banding (bPAB) and subsequent Nw with SPS (bPAB-Nw/SPS), Group III underwent bPAB and subsequent Nw with bidirectional Glenn (BDG) procedure (bPAB-Nw/BDG). The neo-aortic valve z score changes over time did not reach statistical significance in all groups (p = 0.43 for Group I, 0.20 for Group II, and 0.30 for Group III). The degree of neo-aortic valve insufficiency did not change significantly over time during this period except for Group III (p = 0.34 for Group I, 0.20 for Group II, and 0.02 for Group III). On the other hand, dimensions of the neo-aortic annulus and degrees of neo-aortic insufficiency did not differ significantly among the 3 groups at any pre-determined time. The presence or absence of incision into the sino-tubular junction at Nw did not affect the late neo-aortic valve z score or insufficiency. These data indicate that the difference of initial palliative procedures does not affect late neo-aortic valve insufficiency in Nw survivors. Because valve failure may develop in longer follow-up, further observation should be conducted.

Keywords

Hypoplastic left heart syndrome Late neo-aortic insufficiency Norwood operation Bilateral pulmonary artery banding 

Notes

Funding

None declared.

Compliance with ethical standards

Conflict of interest

None declared.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryNagano Children’s HospitalNaganoJapan
  2. 2.Department of Pediatric CardiologyNagano Children’s HospitalNaganoJapan
  3. 3.Department of Cardiovascular Surgery, The Heart Institute of JapanTokyo Women’s Medical UniversityTokyoJapan

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