Larger aortic reconstruction corresponds to diminished left pulmonary artery size in XXXX with single-ventricle physiology.

@entity1 @entity1699
BACKGROUND: Pulmonary artery size is a crucial determinant of hemodynamic energy loss in total cavopulmonary connections. We investigated the effect of aortic arch reconstruction on left pulmonary artery size based on their anatomic proximity. METHODS: Thirty-two @entity1 undergoing the Fontan operation, 16 with @entity1699 and 16 with @entity1699 , were selected from the multicenter Fontan magnetic resonance imaging database at the Georgia Institute of Technology. The 16 datasets were consecutive with full anatomic reconstructions of the total cavopulmonary connection and aortic arch with no artifacts. The size of the aorta along the transverse arch and left pulmonary artery size in the region below the aortic arch was quantified by using a previously validated skeletonization technique. RESULTS: The transverse aortic and left pulmonary artery measurements (median, maximum, and minimum, respectively) for @entity1699 were 2.2, 3.1, and 1.5 cm/m and 1.2, 1.6, and 0.2 cm/m, respectively, compared with 2.5, 4.1, and 2.0 cm/m and 0.9, 1.5, and 0.4 cm/m for @entity1 with @entity1699 . Thus the transverse aortic diameter of @entity1 with @entity1699 was, on average, 24% greater than that for @entity1 with @entity1699 (P < .05), whereas the left pulmonary artery diameter of @entity1 with @entity1699 was smaller than that of @entity1 with @entity1699 (P < .05). Regression analysis showed a significant negative correlation (P < .05) between aortic and left pulmonary artery diameters in both the @entity1699 and @entity1699 groups. However, when the study population was regrouped into reconstructed aorta and nonreconstructed aorta groups, the negative correlation was only significant for @entity1 with reconstructed aortas, regardless of ventricular pathology (P < .02). CONCLUSIONS: Stage 1 aortic reconstruction procedures that result in a large aorta limit left pulmonary artery size in @entity1 undergoing the Fontan operation.
