[Reconstructive surgery of aortic arch interruption in adults].
OBJECTIVE
To evaluate surgical results in adults with aortic arch interruption.


METHODS
Seven patients with aortic arch interruption were operated. Two of them (28.6%) underwent aortic arch repair using allograft, 4 (57.21%) - distal arch and proximal descending aortic replacement, 1 (14.3%) - supra-coronary ascending aortic, aortic arch and proximal descending aortic replacement. All operations were performed under moderate hypothermia (25 °С), circulatory arrest with unilateral cerabral perfusion 8-10 ml/kg/min via innominate artery and pressure 69.6±14.7 mm Hg in arterial.


RESULTS
Cardiopulmonary bypass (CPB) time was 242±36.1 min, aortic cross-clamping - 110.7±40.4 min, circulatory arrest - 58.6±17.9 min. There were no cases of renal insufficiency, vascular lesion of brain and spinal cord, cardiac events. Resternotomy for bleeding was performed in 1 (14.3%) case. Sufficient descending aortic lumen was achieved in 100% according to CT postoperatively. Peak descending aortic pressure gradient after repair with allograft was 29±1.4 mm Hg, after aortic replaement - 10±4.2 mm Hg. Postoperative and in-hospital 30-day mortality was absent.


CONCLUSIONS
Reconstructive surgery for aortic arch interruption in adults is effective approach with good clinical and hemodynamic results.
Research Institute of Cardiology, Tomsk, Russia.
B N
BN
Kozlov
Research Institute of Cardiology, Tomsk, Russia.
D S
DS
Panfilov
Research Institute of Cardiology, Tomsk, Russia.
V V
VV
Saushkin
Research Institute of Cardiology, Tomsk, Russia.
M S
MS
Kuznetsov
Research Institute of Cardiology, Tomsk, Russia.
G G
GG
Nasrashvili
Research Institute of Cardiology, Tomsk, Russia.
V M
VM
Shipulin
D000328:Adult; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001017:Aortic Coarctation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D011859:Radiography; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012800:Siberia; D056346:Sternotomy / Q000706:statistics & numerical data; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000379:methods