OBJECTIVES The aortic arch enlargement in the Norwood procedure is classically carried out using a curved homograft patch on the inner curvature of the neoaortic arch. The study investigates the outcome of a newly used artificial patch from a vascular prosthesis as an alternative to a homograft patch. METHODS Since April 2007, we used curved polytetrafluorethylene (PTFE) patches cut out of a prosthesis as an alternative to homograft patches for the aortic arch reconstruction. The decision for either patch material was made due to anatomic reasons, preferring PTFE patches in larger aortas. In this study, 224 Norwood patients, operated between April 2007 and April 2018, were analysed. A total of 104 patients received a PTFE patch (group PTFE), and 120 patients got a pulmonary homograft patch (group homograft). A single-centre retrospective analysis was carried out concerning postoperative course and long-term follow-up regarding aortic arch interventions and reoperations and comparing the 2 material groups. RESULTS There were no material associated operative or postoperative complications. In-hospital mortality was 13% in group PTFE. Six children died late during follow-up (6%). One aortic isthmus dilatation (1%) was carried out 12 months after the Norwood procedure in this group, no arch reoperation was necessary during the complete follow-up. CONCLUSIONS The curved PTFE patch showed good qualities in operative technical demands and excellent long-term results. In selected cases of hypoplastic left heart syndrome, it can be well used as alternative to the pulmonary homograft.

中文翻译：

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在 Norwood 手术中使用弯曲的聚四氟乙烯贴片重建主动脉弓

目的 Norwood 手术中的主动脉弓扩大通常是在新主动脉弓的内弯上使用弯曲的同种移植补片进行的。该研究调查了新使用的人造血管补片作为同种移植补片替代品的结果。方法 自 2007 年 4 月以来，我们使用从假体上切下的弯曲聚四氟乙烯 (PTFE) 补片作为主动脉弓重建的同种移植补片的替代品。由于解剖学原因，决定使用哪一种补片材料，在较大的主动脉中更喜欢使用 PTFE 补片。在这项研究中，对 2007 年 4 月至 2018 年 4 月期间接受手术的 224 名 Norwood 患者进行了分析。共有 104 名患者接受了 PTFE 补片（PTFE 组），120 名患者接受了肺同种移植补片（组同种移植）。对主动脉弓介入和再手术的术后病程和长期随访进行单中心回顾性分析，并比较两组材料。结果 没有材料相关的手术或术后并发症。PTFE 组的住院死亡率为 13%。6 名儿童在随访期间死亡（6%）。本组在 Norwood 手术后 12 个月进行了一次主动脉峡部扩张（1%），在完整的随访过程中无需再次手术。结论 弯曲的 PTFE 贴片在手术技术要求和长期效果方面表现出良好的品质。在选定的左心发育不全综合征病例中，它可以很好地用作肺同种移植物的替代物。