Off-pump aortic arch repair through a median sternotomy for type B interrupted aortic arch with single ventricle physiology

J Card Surg. 2007 May-Jun;22(3):215-7. doi: 10.1111/j.1540-8191.2007.00388.x.

Abstract

Background: The aortic arch repair for interrupted aortic arch (IAA) with the hypoplastic ascending aorta through a median sternotomy requires cardiopulmonary bypass (CPB), which is very invasive in neonates and complicates pulmonary artery banding (PAB) is staged repair.

Methods: A 22-day-old neonate with a type B IAA having a functional single ventricle underwent arch repair and PAB through a median sternotomy without CPB. A partial occlusion clamp could be placed on the ascending aorta without cerebral malperfusion and the descending aorta could be directly anastomosed to the ascending aorta in an end-to-side fashion under stable circulatory condition. Thereafter, the tight PAB was performed with a circumference of 23mm without any difficulty.

Results: The postoperative echocardiogram revealed no stenosis on the anastomotic site and the patient was discharged uneventfully.

Conclusion: This approach is effective in neonates with IAA who require staged repair, and least invasive for them.

Publication types

  • Case Reports

MeSH terms

  • Aortic Diseases / congenital
  • Aortic Diseases / surgery*
  • Cardiopulmonary Bypass
  • Cardiovascular Surgical Procedures / methods*
  • Heart Defects, Congenital / surgery*
  • Humans
  • Infant, Newborn
  • Male
  • Sternum / surgery
  • Thoracotomy