title: Neonatal coarctation repair with a long isthmus: the isthmus patch.
abstract: This case report illustrates a ductal-dependent coarctation repair in a neonate whose long isthmus was believed to make conventional end-to-end repair problematic. The isthmus and left subclavian artery were isolated and augmented with a homograft while flow to the descending aorta was preserved through the ductus. After patch augmentation of the isthmus, ductal tissue was resected and an end-to-end anastomosis was performed using the length of the augmented isthmus. Angiography 18 months later showed excellent growth of the arch despite homograft tissue comprising the majority of the isthmus at the time of repair.
authors.affiliation: Division of Pediatric Cardiac Surgery, Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, Texas 77030, USA. william.i.douglas@uth.tmc.edu
authors.forename: William I
authors.initials: WI
authors.lastname: Douglas
authors.forename: Monesha
authors.initials: M
authors.lastname: Gupta
authors.forename: Michael H
authors.initials: MH
authors.lastname: Hines
authors.forename: John T
authors.initials: JT
authors.lastname: Bricker
mesh_terms: D001017:Aortic Coarctation / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D014656:Vascular Surgical Procedures / Q000379:methods