Favourable anatomy after end-to-side repair of interrupted aortic arch.
OBJECTIVE
To evaluate cardiovascular outcomes in patients with aortic arch repair and their possible correlation with arch geometry.


METHODS
Ten patients who underwent end-to-side repair for aortic arch interruption (IAA), older than 10 years were compared to a cohort of 10 post coarctation (CoA) repair patients matched for age, sex and age at repair. Mean age at operation was 9.7±6.5 days. Patients underwent a resting and 24 h blood pressure measurements, exercise study, MRI, transthoracic echocardiography and vascular studies.


RESULTS
Seven patients developed hypertension, two from IAA group and five from CoA group. Nine patients (45%) had gothic arch geometry, three from IAA group and six from CoA group. Despite differences in arch geometry, both groups had normal LV mass, LV function and vascular function.


CONCLUSIONS
No differences in functional or morphologic outcomes could be demonstrated between the end-to-side repair of the arch by sternotomy and the conventional coarctation repair by thoracotomy. A favourable arch geometry can be achieved after the end-to-side repair of the aortic arch. In the present study, we could not correlate adverse arch geometry with any adverse cardio-vascular outcomes. After neonatal arch repair, the contributive role of aortic arch geometry to late hypertension remains uncertain.
Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
Jessamine Y J
JY
Liu
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia.
Bryn
B
Jones
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia.
Michael M H
MM
Cheung
Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Australia.
John C
JC
Galati
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia.
Jane
J
Koleff
Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
Igor E
IE
Konstantinov
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
Leeanne E
LE
Grigg
Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
Christian P
CP
Brizard
Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children Research Institute, Melbourne, Australia. Electronic address: yves.dudekem@rch.org.au.
Yves
Y
d'Udekem
D000293:Adolescent; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies
Aortic arch; Aortic coarctation; Comparative studies; Congenital heart disease; Hypertension; Interrupted aortic arch