Aortic Arch Enlargement and Coarctation Repair of Preserving the Lesser Curvature of the Aortic Arch Through a Left Thoracotomy in Neonates

AbstractThe aim of this study was to analyze the aortic arch repair technique for preserving the lesser curvature without cardiopulmonary bypass through a left thoracotomy in neonates with coarctation of the aorta (CoA) and a hypoplastic distal aortic arch (HDAA). HDAA was defined asz-score of the aortic arch  <  − 2.5. Twenty-four neonates with CoA and HDAA were retrospectively studied. Patients underwent enlargement of the HDAA associated with CoA repair when theirz-scores were  <  − 4. They were divided into 2 groups on the basis of the preoperativez-score of the distal aortic arch: group 1 (n = 14),z-score  ≥ − 4; group 2 (n = 10),z-score  <  − 4. Twenty-two patients had intracardiac defects. Follow-up ranged from 0.9 to 20.1 years (median 11.6 years). Thez-scores of the distal aortic arch were significantly smaller in group 2 than group 1 ( − 5.09 ± 1.05 vs − 3.19 ± 0.36,p <  0.001). There were no hospital deaths and no hypertension. All dimensions of the aortic arch in both groups revealed significant catch-up growth (p <  0.02). All patients showed a pressure gradient ≤  5 mmHg across the aortic arch and between the arms and legs at the latest follow-up. Two patients showed an angulated arch deformity over 10 years later. This technique provided good catch-up growth and a low incidence of reobstruction and deformity of reconstructed aortic arch in both groups. These results sug...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research