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One stage repair of aortic arch anomalies and intracardiac defects

One stage repair of aortic arch anomalies and intracardiac defects AbstractBetween August 1985 and May 1990, 27 neonates and infants underwentcombined correction of intracardiac and aortic arch anomalies through amedian sternotomy. Coarctation (CoA) was combined with VSD (6), AVSD (2),Taussig-Bing (TB) heart (5), transposition of the great arteries (TGA) (1),TGA + VSD (2), congenitally corrected TGA + VSD (1) and VSD + myxoidstenotic outlet valves (1). Interrupted aortic arch (IAA) was combined withVSD (10) and TB heart (1). Two patients had IAA type B as well as CoA. Ageat operation varied from 2 to 243 days with a mean age of 51 days. Twentypatients (70%) were younger than 30 days. One TGA + VSD and all TB heartshad maligned outlet septum and right ventricular outflow tract obstruction(RVOTO). Posterior outlet septum deviation and left ventricular outflowtract obstruction (LVOTO) occurred in 8 patients with malalignment VSD andIAA (7) or CoA (1). Aortic arch reconstruction was performed using extendedend-to-end anastomoses. In 3 patients, arch hypoplasia necessitated patchimplantation. VSDs were closed through the right atrium unless the anatomydictated otherwise. One TB heart was reconstructed with a Kawashimaprocedure. All other TB hearts and all TGAs were corrected with arterialswitch operation. Obstructing outlet septum was resected whenevernecessary. Follow-up was complete and included echo-Doppler control. Elevenpatients had postoperative heart catheterisation. Early mortality was 18.5%(5 patients). Persisting LVOTO or RVOTO was responsible. There was no latemortality. Five patients were reoperated upon: 3 for stenotic anastomosesand 2 for a subaortic membranous stenosis. Successful balloon dilatation ofrecoarctation was performed four times.(ABSTRACT TRUNCATED AT 250WORDS) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press

One stage repair of aortic arch anomalies and intracardiac defects

European Journal of Cardio-Thoracic Surgery , Volume 5 (6) – Jun 1, 1991

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Publisher
Oxford University Press
Copyright
© Springer-Verlag 1991
ISSN
1010-7940
eISSN
1873-734X
DOI
10.1016/1010-7940(91)90036-J
Publisher site
See Article on Publisher Site

Abstract

AbstractBetween August 1985 and May 1990, 27 neonates and infants underwentcombined correction of intracardiac and aortic arch anomalies through amedian sternotomy. Coarctation (CoA) was combined with VSD (6), AVSD (2),Taussig-Bing (TB) heart (5), transposition of the great arteries (TGA) (1),TGA + VSD (2), congenitally corrected TGA + VSD (1) and VSD + myxoidstenotic outlet valves (1). Interrupted aortic arch (IAA) was combined withVSD (10) and TB heart (1). Two patients had IAA type B as well as CoA. Ageat operation varied from 2 to 243 days with a mean age of 51 days. Twentypatients (70%) were younger than 30 days. One TGA + VSD and all TB heartshad maligned outlet septum and right ventricular outflow tract obstruction(RVOTO). Posterior outlet septum deviation and left ventricular outflowtract obstruction (LVOTO) occurred in 8 patients with malalignment VSD andIAA (7) or CoA (1). Aortic arch reconstruction was performed using extendedend-to-end anastomoses. In 3 patients, arch hypoplasia necessitated patchimplantation. VSDs were closed through the right atrium unless the anatomydictated otherwise. One TB heart was reconstructed with a Kawashimaprocedure. All other TB hearts and all TGAs were corrected with arterialswitch operation. Obstructing outlet septum was resected whenevernecessary. Follow-up was complete and included echo-Doppler control. Elevenpatients had postoperative heart catheterisation. Early mortality was 18.5%(5 patients). Persisting LVOTO or RVOTO was responsible. There was no latemortality. Five patients were reoperated upon: 3 for stenotic anastomosesand 2 for a subaortic membranous stenosis. Successful balloon dilatation ofrecoarctation was performed four times.(ABSTRACT TRUNCATED AT 250WORDS)

Journal

European Journal of Cardio-Thoracic SurgeryOxford University Press

Published: Jun 1, 1991

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