Innominate artery patency after direct cannulation in neonates

Perry S Choi; Teimour Nasirov; Frank Hanley; Lynn Peng; Doff B McElhinney; Michael Ma

doi:10.1016/j.xjtc.2022.06.001

Innominate artery patency after direct cannulation in neonates

JTCVS Tech. 2022 Jun 9:14:171-176. doi: 10.1016/j.xjtc.2022.06.001. eCollection 2022 Aug.

Authors

Perry S Choi¹, Teimour Nasirov¹, Frank Hanley¹, Lynn Peng², Doff B McElhinney², Michael Ma¹

Affiliations

¹ Department of Cardiothoracic Surgery, Lucile Packard Children's Hospital, Stanford University, Palo Alto, Calif.
² Department of Cardiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, Calif.

Abstract

Objective: The study objective was to determine the short-term incidence of innominate artery stenosis for neonates who underwent direct innominate artery cannulation during the Norwood procedure.

Methods: This is a retrospective, single-institution review of 92 patients who underwent the Norwood procedure with direct innominate artery cannulation from 2006 to 2017. The primary outcome was angiographic evidence of patency at pre-Glenn cardiac catheterization. Patient characteristics, intraoperative surgical and hemodynamic measurements, and postoperative neurologic findings were recorded.

Results: At a median age of 5.0 days, 92 neonates underwent the Norwood procedure with direct innominate artery cannulation. These patients underwent cardiac catheterization at a median of 3.0 months after the index operation. In 5 of 92 patients with catheterization images available for review, there was angiographic evidence of mild innominate artery stenosis, and none had moderate or severe stenosis. Review of follow-up records did not reveal evidence of clinically significant stenosis or innominate artery reintervention.

Conclusions: In neonates undergoing the Norwood procedure with direct innominate cannulation, innominate artery stenosis was uncommon and clinically significant stenosis did not occur.

Keywords: ACP, antegrade cerebral perfusion; NIRS, near-infrared spectroscopy; Norwood; aortic reconstruction; congenital; innominate cannulation; neonate.