Surgical repair of interrupted aortic arch with ventricular septal defect

1998 ◽  
Vol 8 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Lindsey D Allan ◽  
Howard D Apfel ◽  
Yosef Levenbrown ◽  
Jan M Quaegebeur
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Septal Defect ◽  
Ventricular Outflow Tract ◽  
Interrupted Aortic Arch ◽  
Left Ventricular ◽  
Subaortic Stenosis ◽  
Current Debate ◽  
Aortic Orifice

AbstractBackgroundInterrupted 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 ResultsBetween 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.ConclusionsOur 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.

Everting Closure for Interrupted Aortic Arch, Ventricular Septal Defect, and Severe Subaortic Stenosis

1998 ◽  
Vol 46 (01) ◽  
pp. 33-36 ◽  
Author(s):  
T. Watanabe ◽  
K. Tajima ◽  
Y. Sakai ◽  
T. Shimomura ◽  
M. Song ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Septal Defect ◽  
Interrupted Aortic Arch ◽  
Subaortic Stenosis

Interruption of the aortic arch with patency of the arterial duct, discrete subaortic stenosis, restrictive ventricular septal defect and severe pulmonary hypertension—survival to adulthood and successful correction by balloon dilation and surgery

1995 ◽  
Vol 5 (4) ◽  
pp. 367-369
Author(s):  
Robin Joseph Pinto ◽  
Satyavan Sharma ◽  
Nemish Shah
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Septal Defect ◽  
Balloon Dilation ◽  
Left Ventricular ◽  
Subaortic Stenosis ◽  
Complex Situation ◽  
Arterial Duct ◽  
Percutaneous Balloon ◽  
Left Ventricular Outflow

AbstractWe report a case of interruption of the aortic arch associated with patency of the arterial duct, restrictive ventricular septal defect, obstruction of the left ventricular outflow due to a discrete subaortic shelf and severe pulmonary arterial hypertension. The patient survived to adulthood, when a complete angiographic diagnosis was made. The subaortic obstruction was treated by percutaneous balloon dilation performed through a right brachial arteriotomy. Correction of the interrupted arch was carried out surgically using a woven Dacron graft from the aortic arch to the descending thoracic aorta associated with ligation of the duct. Hemodynamic studies after one year revealed a marked decrease in pulmonary vascular resistance and a sustained reduction in the gradient across the left ventricular outflow tract. The case is of interest in the light of the unusual survival and the success of staged management of this complex situation.

The Nikaidoh procedure for complex transposition of the great arteries: short-term follow-up

2016 ◽  
Vol 27 (5) ◽  
pp. 945-950
Author(s):  
Guillermo Ventosa-Fernández ◽  
Carolina Pérez-Negueruela ◽  
Javier Mayol ◽  
Marina Paradela ◽  
José M. Caffarena-Calvar
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Complex Forms

AbstractBackgroundThe surgical treatment for complex forms ofd-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction remains controversial. In this study, we describe the classical surgical options – namely, the Rastelli procedure and the “réparation à l’étage ventriculaire” – and present our experience with the modified Nikaidoh procedure with early and short-term follow-up results.MethodsBetween 2007 and 2014, four patients withd-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction underwent surgical repair at our institution by means of a modified Nikaidoh procedure.ResultsWith a mean follow-up of 4.5 years, survival was 100%, and none of the patients required re-intervention or mechanical circulatory support. There was no recurrence of left ventricular outflow tract obstruction and no aortic valve regurgitation classified as more than mild. Left ventricular function was preserved.ConclusionsAortic translocation with the modified Nikaidoh procedure is a safe and effective surgical treatment for certain complex forms of transposition of the great arteries, particularly those associated with ventricular septal defect and left ventricular outflow tract obstruction. It is associated with less need for re-intervention and better morbidity and mortality results in the short- and mid-term follow-up, when compared with the classical alternatives such as the Rastelli procedure.

Interruption of the aortic arch at the isthmus with DiGeorge syndrome and 22q11.2 deletion

1999 ◽  
Vol 9 (5) ◽  
pp. 516-518 ◽  
Author(s):  
Kazuhiro Takahashi ◽  
Takashi Kuwahara ◽  
Masayoshi Nagatsu
Keyword(s):  
Aortic Arch ◽  
Digeorge Syndrome ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Interrupted Aortic Arch ◽  
Left Ventricular ◽  
22Q11.2 Deletion ◽  
Left Ventricular Outflow

AbstractA 6-day-old male with interruption of the aortic arch at the isthmus (type A) had the typical phenotype of DiGeorge syndrome. There was also a doubly committed juxta-arterial ventricular septal defect and an unobstructed left ventricular outflow tract. Hypoplasia of the thymus was confirmed during a modified Blalock-Park operation. He had persistent hypocalcemia, and was susceptible to infection. He was subsequently revealed by the use of fluorescence in situ hybridization analysis to have 22q11.2 deletion. Interruption of the aortic arch at the isthmus is presumed to reflect abnormal fetal hemodynamics, and is considered a distinct pathogenetic entity from interruption between the left common carotid and subclavian arteries, the latter being the variant more frequently associated with DiGeorge syndrome. In our case, the 22q11.2 deletion likely played a major role in the etiology of the interrupted aortic arch.

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