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Surgical repair of interrupted aortic arch with ventricular septal defect

  • Lindsey D Allan (a1), Howard D Apfel (a1), Yosef Levenbrown (a1) and Jan M Quaegebeur (a2)

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.

Copyright

Corresponding author

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

References

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7.Sell, JE, Jonas, RA, Mayer, JE, Blackstone, EH, Kirkiin, JW, Casteneda, AR.The results of a surgical program for interrupted aortic arch. J Thorac Cardiovasc Surg 1988; 96: 864877.
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9.Luciani, GB, Ackerman, RJ, Chang, AC, Wells, WJ, Starnes, V.One-stage repair of interrupted aortic arch, ventricular septai defect and subaortic obstruction in the neonate: a novel approach. J Thorac Cardiovasc Surg 1996; 111: 348358.

Keywords

Surgical repair of interrupted aortic arch with ventricular septal defect

  • Lindsey D Allan (a1), Howard D Apfel (a1), Yosef Levenbrown (a1) and Jan M Quaegebeur (a2)

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