Faculty Collaboration Database

Porcine Small Intestinal Submucosa May Be a Suitable Material for Norwood Arch Reconstruction. Ann Thorac Surg 2018 Dec;106(6):1847-1852

Date

07/29/2018

Pubmed ID

30055141

DOI

10.1016/j.athoracsur.2018.06.033

Scopus ID

2-s2.0-85054784003 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: Norwood palliation typically requires patch augmentation of the ascending aorta and aortic arch. Patients having undergone Norwood palliation are at risk of recurrent arch obstruction, the risk of which may be affected by the type of patch material used at the time of Norwood palliation. We sought to determine the freedom from neoaortic arch reintervention and overall survival in patients who underwent Norwood palliation utilizing porcine small intestinal submucosa (PSIS) as the patch material.

METHODS: Retrospective chart review was performed to identify patients who underwent a Norwood operation utilizing PSIS material at our institution. Cardiac diagnosis, age at surgery, shunt type, need for reintervention, and outcome (survival, transplant, and death) were evaluated.

RESULTS: Forty-four patients had PSIS material utilized for arch reconstruction at the time of Norwood palliation. There were only five neoaortic arch reinterventions in 4 patients (11.4%). An additional 10 reinterventions, unrelated to the PSIS patch, were performed, including five shunt revisions and five branch pulmonary artery interventions. There were 3 deaths, and 5 patients underwent transplantation. Median follow-up was 387.5 days (range, 4 to 1,513).

CONCLUSIONS: Freedom from neoaortic arch reintervention and survival after Norwood palliation with PSIS patch material is promising. The PSIS appears noninferior and may be an appropriate tissue choice for Norwood palliation. Studies with longer follow-up are needed to determine the rate of neoaortic reintervention over time.

Author List

Jacobsen RM, Mitchell ME, Woods RK, Loomba RS, Tweddell JS

Authors

Michael Edward Mitchell MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Ronald K. Woods MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Animals
Aorta, Thoracic
Female
Humans
Infant
Infant, Newborn
Intestinal Mucosa
Intestine, Small
Male
Norwood Procedures
Retrospective Studies
Swine