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


METHODS
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.


CONCLUSIONS
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.
Sugimori
Haruhiko
H
Division of Pediatric Cardiac Surgery and Cardiology, University of Tsukuba, Tsukuba, Japan.
Abe
Masakazu
M
Kato
Hideyuki
H
Kanemoto
Shinya
S
Noma
Mio
M
Horigome
Hitoshi
H
Takahashi-Igari
Miho
M
Sakakibara
Yuzuru
Y
Hiramatsu
Yuji
Y
D000714:Anastomosis, Surgical / Q000379:methods; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D005260:Female; D006345:Heart Septal Defects, Ventricular; D006801:Humans; D007231:Infant, Newborn; D012307:Risk Factors; D056346:Sternotomy / Q000379:methods; D013348:Subclavian Artery / Q000601:surgery* / Q000637:transplantation; D013524:Surgical Flaps; D013908:Thoracotomy / Q000379:methods