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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 ,
Howard D Apfel ,
Yosef Levenbrown  and
Jan M Quaegebeur
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
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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.

Keywords

nterrupted aortic archcongenital heart diseasesubaortic stenosissurgical repair
Type
Original Articles
Information
Cardiology in the Young , Volume 8 , Issue 2 , April 1998 , pp. 217 - 220
Copyright
Copyright © Cambridge University Press 1998

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References

1.Jacobs, ML, Chin, AJ, Rychik, J, Steven, JM, Nicolson, SC, Norwood, WI.Interrupted aortic arch. Impact of subaortic stenosis on management and outcome. Circ 1995; 92(suppi II):II-128–131.CrossRefGoogle ScholarPubMed
2.Jonas, RA, Quaegebeur, JM, Kirklin, JW, Blackstone, EH, Daicoff, G.Outcomes in patients with interrupted aortic arch and ventricular septal defect. A multiinstitutional study. J Thorac Cardiovasc Surg 1994; 107: 1099–1113.CrossRefGoogle ScholarPubMed
3.Menahem, S, Rahayoe, AU, Brawn, WJ, Mee, RB.Interrupted aortic arch in infancy: a ten-year experience. Pediatr Cardiol 1992; 13: 214–221.CrossRefGoogle Scholar
4.Bove, EL, Minich, LL, Pridjian, AK, Lupinetti, FM, Snider, AR, Dick, M, Beekman, RH.The management of severe subaortic stenosis, ventricular septal defect and aortic arch obstruction in the neonate. J Thorac Cardiovasc Surg 1993; 105: 289–295.CrossRefGoogle ScholarPubMed
5.Geva, T, Hornberger, LK, Sanders, SP, Jonas, RA, Ott, DA, Colan, SD.Echocardiographic predictors of left ventricular outflow tract obstruction after repair of interrupted aortic arch. J Am Coll Cardiol 1993; 22: 1953–1960.CrossRefGoogle ScholarPubMed
6.Hanseus, K, Bjorkhem, G, Lundstrom, NR.Dimensions of cardiac chambers and great vessels by cross-sectional echocardiography in infants and children. Pediatr Cardiol 1988; 9: 7–15.CrossRefGoogle Scholar
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: 864–877.CrossRefGoogle ScholarPubMed
8.Menahem, S, Brawn, WJ, Mee, RB.Severe subaortic stenosis in interrupted aortic arch in infancy and childhood. J Card Surg 1992; 6: 373–380.CrossRefGoogle Scholar
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: 348–358.CrossRefGoogle ScholarPubMed