Abstract
BACKGROUND: This study aimed to compare the early and mid-term outcomes of neo-pulmonary artery (PA) reconstruction using autologous aortic tissue versus pericardial patch in patients undergoing arterial switch operation (ASO), with a specific focus on the development of supravalvular pulmonary stenosis (SVPS). METHODS: This retrospective study included patients who underwent ASO between 2017 and 2024, performed by a single surgical team. Patients were classified into two groups based on the reconstruction material: Group 1 received autologous aortic tissue, while Group 2 received fresh pericardial patch. Demographic characteristics, perioperative data, and follow-up outcomes were analyzed and compared. RESULTS: The study included 36 patients: 26 in Group 1 and 10 in Group 2. The groups were comparable in terms of age, weight, and sex. Cardiopulmonary bypass and cross-clamp times were similar between groups. Median mechanical ventilation duration was significantly shorter in Group 1 (2 vs. 5 days; p = 0.039). Median follow-up durations were 39 months (Group 1) and 47.5 months (Group 2) (p = 0.270). Although mean PA gradients were lower in Group 1, the difference was not significant (20.0 ± 6.31 mmHg vs. 24.63 ± 9.72 mmHg; p = 0.75). Moderate SVPS was detected in one Group 2 patient with concomitant aortic arch reconstruction; no moderate or severe stenosis occurred in Group 1. CONCLUSIONS: The reconstruction of the neo-PA using autologous aortic tissue in ASO offers promising mid-term outcomes. Its potential benefits, compared with traditional methods, warrant further exploration in larger, prospective studies to assess long-term growth potential and the incidence of stenosis or other complications.