Technique of single-stage repair of coarctation of the aorta with ventricular septal defect.
The results of single-stage and two-stage repair of coarctation of the aorta (CoA) with ventricular septal defect (VSD) have improved, but the optimal treatment strategy remains controversial. This article emphasizes the technical details for performing the single-stage repair of CoA with VSD and compares the results of this technique with the two-stage approach. A retrospective analysis of 46 patients who underwent completed surgical repair of CoA with VSD at Children's Hospital of Michigan, either using the single-stage (N=23) or the two-stage (N=23) techniques, was performed. The postoperative complications, hospital mortality, freedom from cardiac re-interventions, and actuarial survival were the same in both groups. The advantages of single-stage over two-stage repair include an earlier age at completion of repair, fewer operations, and fewer incisions. The one disadvantage of a single-stage repair was the increased need for delayed sternal closure compared with the two-stage approach, but this disadvantage has been neutralized in the recent era.
Walters
Henry L
HL
Department of Cardiovascular Surgery, Children's Hospital of Michigan, Detroit, MI 48201, USA. hwalters@dmc.org
Ionan
Constantine E
CE
Thomas
Ronald L
RL
Delius
Ralph E
RE
D000714:Anastomosis, Surgical; D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome