Abstract
Although the classic extended end-to-end repair is the procedure of choice in most neonates and infants with coarctation of the aorta, there is a problem of distance despite extensive mobilization and impairment of growth of the arch because of scarring in some patients. Since December 1999, 15 neonates and infants without significant arch hypoplasia have undergone a modified extended end-to-end repair of coarctation of the aorta at our institution. The anastomosis was performed between the posterior wall of the isthmus and base of the subclavian artery and anterior wall of the descending aorta, resulting in an anastomosis that was usually 1½ times the diameter of the descending aorta. All patients survived and were followed up to 57 months (average, 34). Two patients developed significant gradients 3 months and 1 year postoperatively, respectively, probably from luxurious tissue growth at the suture line. Both were treated successfully with balloon dilatation. The modified extended end-to-end repair provides another option for repair of coarctation in neonates and infants. It requires less mobilization of the arch and descending aorta. It is particularly useful in patients with long isthmus.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Backer CL, Mavroudis C, Zias EA, Amin Z, Weigel TL (1998) Repair of coarctation with resection and extended end-to-end anatomosis. Ann Thorac Surg 66:1365–1371
Cobanoglu A, Tefly F, Grunkemeier GL, Sunderland CO, Starr A (1985) Coarctation of the aorta in patients younger than three months. A critique of the subclavian flap operation. Thorac Cardiovasc Surg 89:128–135
Conte S, Lacour-Gayet F, Serraf A, et al (1995) Surgical management of neonatal coartation. J Thorac Cardiovasc Surg 109:663–675
Elliott ML (1987) Coarctation of the aorta with arch hyoplasia: improvement on a new technique. Ann Thorac Surg 44:321
Lacour-Gayet F, Bruniaux J, Serraf A, et al (1990) Hypoplastic transverse arch and coarctation in neonates. Surgical reconstruction of the aortic arch: a study of sixty-six patients. J Thorac Cardiovasc Surg 100:808–816
Lansman S, Shapiro AJ, Schiller MS, et al (1986) Extended aortic arch anastomosis for repair of coarctation in infancy. Circulation 74(suppl 1):137–141
Pellegrino A, Deverall PB, Anderson RH, et al (1985) Aortic coarctation in the first three months of life. An anatomopathological study with respect to treatment. J Thorac Cardiovasc Surg 89:121–127
Quaegebeur JM, Jonas RA, Winberg AD, Blackstone EH, Kirklin JW, Congenital Heart Surgeons Society (1994) Outcomes in seriously ill neonates with coarctation of the aorta. A multiinstitutional study. J Thorac Cardiovasc Surg 108:841–854
van Heurn LWE, Wong CM, Spiegelhalter DJ, et al (1994) Surgical treatment of aortic coarctation in infants younger than three months: 1985 to 1990. J Thorac Cardiovasc Surg 107:74–86
Vouhe PR, Trinquet PR, Lecompte Y, et al (1988) Aortic coarctation with hypoplastic aortic arch. Results of extended end-to-end aortic arch anastomosis. J Thorac Cardiovasc Surg 96:557–563
Zannini L, Gargiulo G, Albanese SB, et al (1993) Aortic coarctation with hypoplastic arch in neonates; a spectrum of anatomic lesions requiring different surgical options. Ann Thorac Surg 56:288–294
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Deleon, S., Desikacharlu, A., Dorotan, J. et al. Modified Extended End-To-End Repair of Coarctation in Neonates and Infants. Pediatr Cardiol 28, 355–357 (2007). https://doi.org/10.1007/s00246-005-0986-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-005-0986-4