Reintervention following infant aortic arch repair using a tailored autologous pericardial patch.

Abstract Background Aortic arch reobstruction is a common complication following aortic repair, with rates of reintervention varying from 0 to 40%, depending on the pathology and institution. This study aims to determine the reintervention rate in children undergoing aortic arch repair using a tailored autologous pericardial patch at our center. Methods This retrospective study examines all patients operated by a single surgeon for aortic arch reconstruction via sternotomy, from 2011-2018, with one year of follow-up. Our dataset was analyzed for normality using the Shapiro-Wilk Test, and non-parametric statistical methods were used. Kaplan-Meier survival analysis was performed, IBM SPSS version 23 was used to perform all statistical analysis. Results One hundred seventy-one patients met inclusion criteria. Twenty-three (13.5%) patients underwent aortic arch reinterventions during the study period, 17 (9.9%) catheter-based and 3 (1.8%) surgical. Three patients (1.8%) had both. Freedom from reintervention at 1 year follow up for the univentricular and biventricular patients was 82.1% and 89.4% p=0.174 respectively. To assess the growth of the aortic arch over time, cardiac catherization measurements were used to index different parts of the aortic arch against the descending aorta. Ascending:descending aortic arch measurements revealed pre-Glenn median was 2.0 (IQR 1.8-2.2), while pre-Fontan median was 2.5 (IQR 2.2-2.7) (p Conclusions There was no significant difference in reintervention rates between biventricular and univentricular arches and catherization measurements showed significant growth of the arch over time. The use of a tailored autologous pericardial patch for aortic arch repair is comparable to other reported methods of arch repair.