A modification of extended aortic arch anastomosis augmented with subclavian flap aortoplasty for interrupted or hypoplastic aortic arch

J Card Surg. 2009 Sep-Oct;24(5):561-3. doi: 10.1111/j.1540-8191.2009.00859.x. Epub 2009 May 15.

Abstract

Background: Surgical repair for hypoplastic aortic arch in neonates carries a substantial risk of recurrent obstruction. Simple arch anastomosis is not always a solution in cases of extended arch hypoplasia. We present our modified technique of extended aortic arch anastomosis augmented with subclavian flap aortoplasty.

Method: We describe two neonates: interrupted aortic arch and transverse arch hypoplasia associated with aortic coarctation, who underwent a modification of extended aortic arch anastomosis augmented with subclavian flap aortoplasty.

Results: The patients recovered without any pressure gradient at the anastomotic site. Postoperative aortography showed no arch obstruction and they successfully underwent second stage repair.

Conclusion: Our technique provides extensive augmentation of the aortic arch with a tension-free, wide and non-circumferential suture line which preserves potential for growth. The technique described may avoid persistent or repeat arch obstruction.

MeSH terms

  • Anastomosis, Surgical / methods
  • Aorta, Thoracic / pathology
  • Aorta, Thoracic / surgery*
  • Female
  • Heart Septal Defects, Ventricular
  • Humans
  • Infant, Newborn
  • Risk Factors
  • Sternotomy / methods
  • Subclavian Artery / surgery*
  • Subclavian Artery / transplantation
  • Surgical Flaps*
  • Thoracotomy / methods