title: Subclavian flap aortoplasty and preservation of left upper extremity circulation using an interposition graft.
abstract: OBJECTIVE
  To introduce a surgical technique to maintain left upper limb blood flow after subclavian flap aortoplasty (SFA).
  
  
  METHODS
  Five patients (9 to 23 months of age) with a diagnosis of long-segment aortic coarctation underwent conventional SFA. A Gore-tex graft was interposed between the stump and the proximal descending aorta to maintain perfusion of subclavian artery.
  
  
  RESULTS
  All patients had a patent Gore-tex graft and normal blood flow of the subclavian artery and left upper limb. One patient expired and four others were discharged with a mean follow-up of 48 months. On follow-up all patients had normal development of the left upper limb and no signs of limb ischemia. Echo findings revealed normal arch flow with normal flow in the Gore-tex graft and left upper extremity.
  
  
  CONCLUSIONS
  Interposing a Gore-tex graft between the subclavian artery stump and proximal descending aorta concomitant with SFA can be safely performed in infants with long-segment aortic coarctation, with preservation of left upper extremity circulation.
authors.affiliation: Department of Cardiothoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Khalil
authors.initials: K
authors.lastname: Zarrabi
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.forename: Nima
authors.initials: N
authors.lastname: Zamiri
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Ostovan
mesh_terms: D001011:Aorta / Q000601:surgery; D001017:Aortic Coarctation / Q000401:mortality / Q000601:surgery*; D001132:Arm / Q000098:blood supply*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007511:Ischemia / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000517:prevention & control; D013348:Subclavian Artery / Q000502:physiology / Q000637:transplantation*; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene