Arch Repair Technique (Pulmonary Artery Trunk Saving) in the Norwood Procedure

Abstract

The classic first stage of the Norwood procedure uses a homograft patch enlargement to obtain an unobstructed aorta and coronary arteries due to insufficient native tissue to reconstruct a neo aorta. However, there are some possible disadvantages of the homograft, such as lack of growth, degeneration, calcification, and unavailability. The pulmonary artery trunk saving technique was developed as a no-patch technique to minimize patch augmentation during the reconstruction of the neo aorta in the Norwood procedure. The pulmonary artery trunk was longer and narrowed, to make the left aortopulmonary space wider, to avoid extrinsic compression of the left pulmonary artery and bronchus by the neo aorta. This technique was developed based on the advantages of the anatomy of specific great vessels in patients with hypoplastic left heart syndrome.