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Surgical repair of interrupted aortic arch with ventricular septal defect

Published online by Cambridge University Press:  19 August 2008

Lindsey D Allan*
Affiliation:
Department of Pediatric Cardiology, Babies Hospital, Columbia Presbyterian Medical Center, New York, USA
Howard D Apfel
Affiliation:
Department of Pediatric Cardiology, Babies Hospital, Columbia Presbyterian Medical Center, New York, USA
Yosef Levenbrown
Affiliation:
Department of Pediatric Cardiology, Babies Hospital, Columbia Presbyterian Medical Center, New York, USA
Jan M Quaegebeur
Affiliation:
Department of Surgery, Babies Hospital, Columbia Presbyterian Medical Center, New York, USA
*
Dr Lindsey Allan, Department of Pediatric Cardiology, Babies Hospital 2N, Columbia Presbyterian Medical Center, 3959 Broadway, New York, NY 10032. Tel. 212-305-6542 Fax. 212-305-4429. Email la48@columbia.edu

Abstract

Background

Interrupted aortic arch is often associated with subaortic narrowing and hypoplasia of the aortic orifice. The best surgical strategy for the management of these additional lesions is a matter of current debate.

Methods and Results

Between 1986 and 1996, 19 patients underwent repair of interrupted aortic arch with closure of ventricular septal defect in a single stage, with no attempt at subaortic resection, irrespective of the dimensions of the left ventricular outflow tract. There was no perioperative hospital mortality, and all patients were alive at 1 year. Follow-up ranges from 0.75 −10 years, with a mean 4.2 ± 3.0 years. Seven patients (37%) have required reintervention for relief of subaortic stenosis, 2 of whom have died.

Conclusions

Our results suggest that primary one-stage biventricular repair can be accomplished with low perioperative mortality without addressing the subaortic region. Further long-term follow-up will determine whether this is accomplished at the expense of later morbidity and mortality.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1998

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