title: Single institutional experience of interrupted aortic arch repair over 28 years.
abstract: A single institutional outcome of the biventricular repair for congenital heart disease with interrupted aortic arch between 1982 and 2010 were retrospectively reviewed. There were 48 consecutive patients with a mean follow-up of 10.0 ± 7.9 years. The staged repair was applied in 27 patients, and primary complete repair was applied in 21. The actuarial survival was 79.0% at 10 years. There was a significant difference in survival between the patients operated before 2000 and after 2001 (65.2 vs. 100% at 10 years, P = 0.005), but not in survival between the staged repair and the primary complete repair (77.4 vs. 81.0% at 10 years, P = 0.793). There was no significant difference in freedom from unplanned reoperation between the staged repair and the primary complete repair (47.9 vs. 70.6% at 5 years, P = 0.249). No patients with primary complete repair had reoperation for left ventricular outflow tract obstruction, whereas five patients with staged repair did. The patients with interposition graft placement between ascending and descending aorta had significantly low freedom from reoperation for the aortic arch compared with other techniques (7.2 vs. 90.0% at 10 years, P = 0.001). In conclusion, surgical outcomes for interrupted aortic arch have been significantly improved in the last decade and the staged repair remains an effective option in selected patients.
authors.affiliation: Division of Pediatric and Congenital Cardiothoracic Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA. tshinkawa@uams.edu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinkawa
authors.forename: Robert D B
authors.initials: RD
authors.lastname: Jaquiss
authors.forename: Michiaki
authors.initials: M
authors.lastname: Imamura
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities / Q000601:surgery*; D001131:Arkansas; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome