title: A modification of extended aortic arch anastomosis augmented with subclavian flap aortoplasty for interrupted or hypoplastic aortic arch.
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.
  
  
  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.
authors.affiliation: Division of Pediatric Cardiac Surgery and Cardiology, University of Tsukuba, Tsukuba, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sugimori
authors.forename: Masakazu
authors.initials: M
authors.lastname: Abe
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Shinya
authors.initials: S
authors.lastname: Kanemoto
authors.forename: Mio
authors.initials: M
authors.lastname: Noma
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Horigome
authors.forename: Miho
authors.initials: M
authors.lastname: Takahashi-Igari
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Sakakibara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
mesh_terms: 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