Yasui Operation after Norwood Procedure for VSD with Aortic Atresia or Interrupted Aortic Arch

Shu-chien Huang, HengWen Chou, YihSharng Chen

National Taiwan University Hospital, Taipei, Taiwan

Date, time and location: 2018.05.26 08:30, Press Hall, 2F

Abstract

Introduction: The Yasui operation could achieve bi-ventricular reconstruction for patients with adequatesized ventricles and ventricular septal defect(VSD) associated with obstructions of the aortic arch and left ventricular outflow tract (LVOT). The experience of Yasui opertion following Norwood operation with RV-PA shunt were reviewed. Material and 

Method: Since 2014, 5 patients have undergone the Yasui operation at our institution. Interrupted aortic arch was present in 3 patients and coarctation of the aorta/hypoplastic arch was present in 2. Two patients had aortic stenosis, and 3 patients had aortic atresia. All patients had Norwood S1P with RV-PA shunt as initial palliation. The mean age and body weight at the time of the Yasui operation was 17.4 ±14.2 months and 8.0 ± 2.3 kg, respectively. The ascending aorta and aortic arch requires graft interposition in 3. Right ventricle to pulmonary artery continuity was established with a valved Gortex conduit in 4 patients, and 19mm Tissue valve in one. 

RESULTS: All five patients had successful Norwood palliation and survived Yasui operation. During the follow-up, there were no late death. One patient underwent re-operation for peripheral pulmonary artery stenosis and change the conduit. All the other patients had good functional outcome without LVOT obstruction. 

CONCLUSIONS: The results of the Staged Norwood - Yasui operation were excellent. Low mortality and good midterm left ventricular function without outflow tract stenosis could be achieved. The long-tem follow-up is required for the patency of RVOT conduits.