title: Repair of recoarctation and aortic valve replacement with the On-X valve in a pediatric patient: a case report.
abstract: A 10-year-old boy had undergone conventional two-stage surgery that included repair of aortic coarctation with pulmonary artery banding as an initial operation followed by closure of a ventricular septal defect as a secondary procedure. Following these procedures, aortic coarctation recurred, and balloon angioplasty was performed three times. Aortic recoarctation, however, persisted, and aortic stenosis and regurgitation and pulmonary stenosis gradually developed. An operation was therefore performed to repair recoarctation, aortic stenosis and regurgitation, and pulmonary stenosis. Patch aortoplasty was performed for recoarctation. The aortic valve was replaced with a 19 mm On-X valve, with Konno root enlargement. Pulmonary arterial patch plasty was also performed. During aortic arch reconstruction, selective cerebral perfusion was performed via the innominate artery and left carotid artery, and the lower half of the body was perfused through a cannula in the left femoral artery. The postoperative course was uneventful, and aortography revealed a well-reconstructed aortic arch free of obstruction. There were no valve-related complications.
authors.affiliation: Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-shi, Tokyo 183-003, Japan. tsasakister@gmail.com
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Ando
authors.forename: Naoki
authors.initials: N
authors.lastname: Wada
mesh_terms: D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000601:surgery; D002648:Child; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D012008:Recurrence; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures