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J Thorac Cardiovasc Surg 2011;141:1083-1084
© 2011 The American Association for Thoracic Surgery

Brief Technique Report

Valve-sparing neo-aortic root replacement after Fontan completion for hypoplastic left heart syndrome

^a Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Deleware
^b Division of Diagnostic Pathology, Alfred I. duPont Hospital for Children, Wilmington, Deleware

Received for publication May 14, 2010; revisions received June 27, 2010; accepted for publication July 31, 2010.

^_* Address for reprints: Christian Pizarro, MD, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803. (Email: cpizarro@nemours.org).

The first 20% of the full text of this article appears below.

	Introduction

 
Development of neo-aortic root dilatation is a well-known entity among patients with congenital heart defects in whom the native pulmonary root is placed in the systemic position.^1,2 Patients undergoing a Norwood procedure constitute no exception. Valve-sparing aortic root replacement, a procedure commonly utilized to treat aortic root dilatation among patients with connective tissue disorders, can be an effective form of therapy for this condition.

	Clinical Summary

 
A 10-year-old patient status post-Fontan completion for hypoplastic left heart syndrome (HLHS) (aortic atresia, mitral atresia) demonstrated progressive neoaortic (native pulmonary) root dilatation during follow-up. A computed tomographic scan of the chest revealed an aortic root aneurysm with a diameter of 5.4 cm at the level of the sinuses of Valsalva (z-score 12, based on normative data for native aortas). Although the neo-aortic valve remained competent, near complete obliteration of the left pulmonary artery by the expanding aortic root was seen (Figure 1 ).

View larger version (5K):   Figure 1. Computed tomographic angiogram reconstruction illustrating the aneurysmal involvement of the neo-aorta mainly at the expense of . . . [Full Text of this Article]