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Comparative outcome analysis of direct anastomosis and bovine pericardial patch augmentation techniques in arch reconstruction for paediatric patients

Published online by Cambridge University Press:  28 February 2025

Mustafa Yilmaz Open the ORCID record for Mustafa Yilmaz [Opens in a new window] ,
Basak S.Turkcan Open the ORCID record for Basak S.Turkcan [Opens in a new window] ,
Ata N. Ecevit ,
Denizhan Bagrul  and
Atakan Atalay
Mustafa Yilmaz*
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
Basak S.Turkcan
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
Ata N. Ecevit
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
Denizhan Bagrul
Affiliation:
Department of Pediatric Cardiology, Ankara Bilkent City Hospital, Ankara, Turkey
Atakan Atalay
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
*
Corresponding author: Mustafa Yilmaz; Email : [email protected]
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Abstract

Introduction:

The treatment for proximal aortic arch hypoplasia in paediatric patients is still controversial. While some authors favours direct tissue anastomosis, others state that patch augmentation may also be a good alternative. The aim of this study is to compare the results of arch reconstructions using bovine pericardium with the direct anastomosis technique.

Materials and method:

Paediatric patients who underwent arch reconstruction via median sternotomy between 2019 and 2023 were evaluated. Patients were divided into two groups according to the repair method of arch reconstructions: direct native tissue anastomosis and bovine pericardial patch augmentation. Using perioperative data, the relationship between the surgical method and postoperative morbidity, in-hospital mortality, and the risks for early reintervention was investigated.

Results:

Between August 2019 and August 2023, 38 paediatric patients underwent arch reconstruction. The average age and weight of the patients were 40 days (15–157.5 days, interquartile) and 3.78 kg (3.2–6.0 kg, interquartile range), respectively. While completely native tissue anastomosis was applied in 18 of the patients (47.4%), bovine pericardial patch was used in arch reconstruction in 20 patients (52.6%). Cross-clamp time was found to be significantly longer in patients using bovine patches (p = .016). No difference was detected between the two surgical methods in terms of postoperative mortality and morbidity factors (p > .05). There was no significant difference between the two surgical procedures in terms of reintervention in the early period after discharge (p = .177).

Conclusion:

Although early results of both reconstruction techniques may be promising, their reliability needs to be evaluated in detail with large-scale prospective studies.

Keywords

Bovine pericardiumhipoplastic archpaediatric
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 7
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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