The Journal of Thoracic and Cardiovascular Surgery, Vol 82, 98-102, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Transmediastinal repair of complex coarctation and interrupted aortic arch
SY DeLeon, FS Idriss, MN Ilbawi, N Tin and T Berry
In the past 2 years, eight patients have had repair of coarctation of the
aorta or interrupted aortic arch along with an intracardiac procedure
performed through a simple midsternotomy. Five underwent total repair and
three had palliation for the intracardiac lesion. Four patients did well
(including one who required a resection for recoarctation), two died
intraoperatively, and two died postoperatively (11 and 21 days), one of
them from clostridial sepsis and the other from cerebral anoxia that
followed a cardiac arrest precipitated by a massive hemoptysis. We found
that with this approach the aortic obstruction could be readily relieved
and the intracardiac procedure carried out. Since the majority of these
patients have compromised hemodynamic status, the ease of instituting
immediate bypass, avoidance of a separate incision, and feasibility of
total repair are major advantages.
