Abstract
The diminutive aorta presents technical challenges in the palliation of hypoplastic left heart syndrome. Furthermore, aortic arch caliber changes and variable great vessel relationships can add complexity to an already difficult arch repair. We describe a technical approach that simplifies the aortic reconstruction and makes the procedure more generalizable and reproducible.
Highlights
Hypoplastic Left Heart Syndrome (HLHS) is a spectrum of cardiac malformations that has a high morbidity and mortality
We describe a simple, reproducible technique that simplifies the surgical approach to the diminutive aorta in patients with hypoplastic left heart syndrome
There are several modifications of the original procedure, including the transection of the ascending aorta introduced by van Son, Mosca and Thistlewaiste to reconstruct the systemic outlet in ventriculoarterial discordance and hypoplastic aorta [4,5,6]
Summary
Hypoplastic Left Heart Syndrome (HLHS) is a spectrum of cardiac malformations that has a high morbidity and mortality. HLHS is comprised of underdeveloped left sided heart structures, characterized by aortic atresia or severe stenosis, which results in a small left ventricle and a hypoplastic, sometimes diminutive ascending aorta [1]. One-month mortality approaches 95% [2]. The arch reconstruction technique in such patients can be quite demanding, and achieving an adequate three dimensional conformation of all components (ascending aorta, aortic arch, proximal descending aorta and pulmonary root), coupled to the homograft patch can be difficult. We describe a simple, reproducible technique that simplifies the surgical approach to the diminutive aorta in patients with hypoplastic left heart syndrome
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