Wide Dissection and Intercostal Vessel Division Allows for Repair of Hypoplastic Aortic Arch Through Thoracotomy

2018 ◽  
Vol 9 (6) ◽  
pp. 659-664 ◽  
Author(s):  
Néstor F. Sandoval ◽  
Catalina Vargas Acevedo ◽  
Juan Bernardo Umaña ◽  
Ivonne Pineda ◽  
Albert Guerrero ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Postoperative Mortality ◽  
Coarctation Of The Aorta ◽  
Adverse Outcomes ◽  
Modified Technique ◽  
Exclusion Criteria ◽  
Descending Aorta ◽  
Significant Difference ◽  
Hypoplastic Aortic Arch ◽  
Lateral Thoracotomy

Background: The approach to coarctation of the aorta with hypoplastic aortic arch is controversial. We evaluated the outcomes in patients with coarctation of the aorta with or without hypoplastic aortic arch operated through a posterior left lateral thoracotomy. Methods: A retrospective cohort of patients with aortic coarctation, who underwent repair between January 2009 and October 2017, was analyzed. Preoperative, postoperative, and echocardiographic characteristics were reviewed. Statistical analysis examined survival, freedom from reintervention, and freedom from recoarctation. Results: In nine years, 389 patients who underwent surgical treatment for coarctation of the aorta were identified; after exclusion criteria and complete echocardiographic reports, 143 patients were analyzed, of which 29 patients had hypoplastic aortic arch. The modification in the extended end-to-end anastomosis technique was a wide dissection and mobilization of the descending aorta that was achieved due to the ligation and division of 3 to 5 intercostal vessels. In both groups, patients were close to one month of age and had a median weight of 3.6 and 3.4 kg for hypoplastic and nonhypoplastic arch, respectively. In postoperative events, there was no statistically significant difference between the groups ( P = .57 for renal failure, P = .057 for transient, nonpermanent neurologic events, P = .496 for sepsis), as for intensive care unit ( P = .502) and total in-hospital stay ( P = .929). There was one case of postoperative mortality in each group and both were associated with noncardiac comorbidities. Regarding survival (log-rank = 0.060), freedom from reintervention (log-rank = 0.073), and freedom from recoarctation (log-rank = 0.568), there was no statistically significant difference between the groups. Conclusion: We believe that it is the modified technique that allowed greater mobilization of the aorta and successful repair of hypoplastic arch through thoracotomy, without an increase in paraplegia or other adverse outcomes.

Transcatheter mechanical thrombectomy of neonatal occlusive aortic thrombus using an Amplatzer Piccolo PDA occluder

2021 ◽  
pp. 1-3
Author(s):  
Christopher Herron ◽  
Stuart Covi ◽  
Athina Pappas ◽  
Daisuke Kobayashi
Keyword(s):  
Aortic Arch ◽  
Critical Condition ◽  
Mechanical Thrombectomy ◽  
Coarctation Of The Aorta ◽  
Premature Neonate ◽  
Interrupted Aortic Arch ◽  
Thromboembolic Events ◽  
Descending Aorta ◽  
Aortic Thrombus

Abstract Neonatal aortic thrombus is a rare and critical condition that can present mimicking severe coarctation of the aorta or interrupted aortic arch. Transcatheter thrombectomy for this lesion has not been well described. We report a premature neonate with an occlusive proximal descending aorta thrombus, who underwent transcatheter mechanical thrombectomy using an Amplatzer Piccolo PDA occluder (Abbott, North Chicago, IL, USA). The procedure was successful with no subsequent distal thromboembolic events.

One-stage repair with separated cardiopulmonary bypass for coarctation of the aorta with left aortic arch and right thoracic descending aorta

2012 ◽  
Vol 60 (9) ◽  
pp. 575-577
Author(s):  
Masatoshi Shimada ◽  
Takaya Hoashi ◽  
Koji Kagisaki ◽  
Tatsuya Oda ◽  
Isao Shiraishi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Coarctation Of The Aorta ◽  
Descending Aorta ◽  
One Stage

Truncus arteriosus communis in combination with cor triatriatum sinsitrum

2015 ◽  
Vol 26 (1) ◽  
pp. 194-196
Author(s):  
Elmar Klusmeier ◽  
Nikolaus A. Haas ◽  
Eugen Sandica
Keyword(s):  
Surgical Treatment ◽  
Aortic Arch ◽  
Septal Defect ◽  
Coarctation Of The Aorta ◽  
Venous Drainage ◽  
Truncus Arteriosus ◽  
Unique Case ◽  
Cardiac Defects ◽  
Hypoplastic Aortic Arch

AbstractTruncus arteriosus communis is a rare CHD, accounting for only 1% of all congenital cardiac abnormalities. It has been associated with other malformations of the heart, mainly truncal valve (bicuspid/quadricuspid) and aortic arch abnormalities such as right, interrupted, and hypoplastic aortic arch. Cor tratriatrum sinistrum is another rare CHD, and it has been associated with other cardiac defects such as anomalous pulmonary venous drainage, ventricular septal defect, coarctation of the aorta, and tetralogy of Fallot. The combination of truncus arteriosus communis and cor tratriatrum sinistrum has not been reported so far. This case study describes the diagnosis of a unique case, including these two very rare cardiac defects and the successful surgical treatment thereafter.

Abnormal histology of the aortic arch in coarctation of the aorta

1993 ◽  
Vol 3 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Derk W. Wolterbeek ◽  
Arie P. Kappetein ◽  
Adriana C. Gittenberger–de Groot
Keyword(s):  
Neural Crest ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Lower Number ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Cardiac Neural Crest ◽  
The Media

SummaryWe examined the number of elastic lamellae in the wall of the proximal aortic arch, aortic isthmus and descending aorta in patients with coarctation of the aorta. In the proximal aortic arch, the number of elastic lamellae was significantly lower in patients with coarctation compared to those with normal hearts without aortic anomalies and those with intracardiac defects but without aortic anomalies. The isthmus also showed a significantly lower number of elastic lamellae in the presence of preductal coarctation. In the descending aorta, the number of elastic lamellae was not significantly different between the different groups. There is doubt about the etiology of coarctation. Recent investigations showed that cells from the cardiac neural crest contribute to the formation of the arch arteries and the media of the arch. A developmental error of the neural crest might be responsible for the abnormal mural structures found in patients with aortic coarctation.

scholarly journals An Alternative Technique for Ascending and Arcus Aorta Repair in Case of Vascular Diameter Mismatch

2020 ◽  
Vol 23 (2) ◽  
pp. E255-E257
Author(s):  
Bulend Ketenci ◽  
Tamer Kehlibar ◽  
Abdulkerim Özhan ◽  
Mehmet Yilmaz ◽  
Erhan Guler ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Vascular Graft ◽  
Intramural Hematoma ◽  
Type A ◽  
Alternative Technique ◽  
Modified Technique ◽  
Descending Aorta ◽  
Surgical Options ◽  
Aortic Arch Repair ◽  
Intimal Tear

Complicated Type A intramural hematoma involving the arcus aorta requires emergency correction of the aortic arch. Surgical options include reimplantation of the brachiocephalic vessels as an island to a vascular graft, debranching aortic arch surgery, and Kazui technique. This report describes a modified technique for aortic arch repair in a patient with vascular diameter mismatch between the ascending and descending aorta, as well as an intimal tear between the brachiocephalic vessels.

scholarly journals Off-pump hypoplastic aortic arch ± aortic coarctation repair via median sternotomy using a temporary shunt

2020 ◽  
Vol 31 (5) ◽  
pp. 748-750
Author(s):  
Zohair Al Halees ◽  
Ibrahim Abdullah
Keyword(s):  
Side Effects ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Median Sternotomy ◽  
Coarctation Of The Aorta ◽  
Off Pump ◽  
Coarctation Repair ◽  
Temporary Shunt ◽  
Hypoplastic Aortic Arch ◽  
Aortic Arch Hypoplasia

Abstract An off-pump technique was developed to surgically manage the problem of aortic arch hypoplasia frequently associated with coarctation of the aorta and borderline size left-sided structures. The technique was successfully utilized in 5 patients adequately repairing the arch without any side effects.

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