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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)
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: Jun 1, 1991
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