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The Journal of Thoracic and Cardiovascular Surgery, Vol 96, 557-563, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
PR Vouhe, F Trinquet, Y Lecompte, F Vernant, PM Roux, G Touati, G Pome, F Leca and JY Neveux
Between 1980 and 1986, 80 infants (less than or equal to 3 months old) with
symptomatic aortic coarctation and associated severe tubular hypoplasia of
the transverse aortic arch underwent surgical treatment. Extended
end-to-end aortic arch anastomosis was used in an attempt to correct both
the isthmic stenosis and the hypoplasia of the transverse arch. After
complete excision of the coarctation tissue, a long incision was made in
the inferior aspect of the aortic arch, which was then anastomosed to the
obliquely trimmed distal aorta. Pure coarctation was present in 17 patients
(group I); 24 infants had an additional ventricular septal defect (group
II), and 39 patients had associated complex heart disease (group III). The
overall early mortality rate was 26% (confidence limits 21% to 32%) (18% in
group I, 17% in group II, and 36% in group III). The early risk declined
with time and was 18% (confidence limits 12% to 26%) for the last 2 years
(seven deaths in 39 patients). Follow-up was 100% for a mean of 19 months.
Actuarial survival rate at 3 years was 82% for group I, 78% for group II,
and 32% for group III. Recurrent coarctation (gradient greater than or
equal to 20 mm Hg) occurred in six operative survivors (10%, confidence
limits 6% to 16%) and necessitated reoperation in three. Freedom from
recoarctation at 4 years was 88%. Because extended end-to-end aortic arch
anastomosis provides adequate correction of the aortic obstruction and
entails a low risk of restenosis, it is our procedure of choice in infants
with coarctation and severe hypoplasia of the aortic arch.
ARTICLES
Aortic coarctation with hypoplastic aortic arch. Results of extended end-to-end aortic arch anastomosis
Service de Chirurgie Thoracique et Cardiovasculaire, Hopital Laennec, Paris, France.
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M. M. DeLeon, S. Y. DeLeon, J. A. Quinones, P. T. Roughneen, K. E. Magliato, D. A. Vitullo, F. Cetta, T. J. Bell, and E. A. Fisher Management of Arch Hypoplasia After Successful Coarctation Repair Ann. Thorac. Surg., April 1, 1997; 63(4): 975 - 980. [Abstract] [Full Text]
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S. Conte, F. Lacour-Gayet, A. Serraf, M. Sousa-Uva, J. Bruniaux, A. Touchot, C. Planche, and S. b. A. Castaneda Surgical management of neonatal coarctation J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 663 - 675. [Abstract] [Full Text]
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S. Y. DeLeon, F. X. Downey, N. E. Baumgartner, E. P. Ow, J. A. Quincnes, L. Torres, M. N. Ilbawi, and R. Pifarre Transsternal repair of coarctation and associated cardiac defects Ann. Thorac. Surg., July 1, 1994; 58(1): 179 - 184. [Abstract] [PDF]
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L. W. E. van Heurn, C. M. Wong, D. J. Spiegelhalter, K. Sorensen, M. R. de Leval, J. Stark, and M. J. Elliott Surgical treatment of aortic coarctation in infants younger than three months: 1985 to 1990Success of extended end-to-end arch aortoplasty J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 74 - 86. [Abstract] [Full Text]
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A. P. Kappetein, A. H. Zwinderman, A. J. J. C. Bogers, J. Rohmer, and H. A. Huysmans More than thirty-five years of coarctation repairAn unexpected high relapse rate J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 87 - 95. [Abstract] [Full Text]
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L. Zannini, G. Gargiulo, S. B. Albanese, M. C. Santorelli, G. Frascaroli, F. M. Picchio, and A. Pierangeli Aortic coarctation with hypoplastic arch in neonates: A spectrum of anatomic lesions requiring different surgical options Ann. Thorac. Surg., August 1, 1993; 56(2): 288 - 294. [Abstract] [PDF]
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J. L. Myers, B. A. McConnell, and J. A. Waldhausen Coarctation of the aorta in infants: Does the aortic arch grow after repair? Ann. Thorac. Surg., November 1, 1992; 54(5): 869 - 875. [Abstract] [PDF]
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P. S. Rao and P. S. Chopra Reply Ann. Thorac. Surg., September 1, 1992; 54(3): 600 - 602. [PDF]
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P. L. Ergina and C. I. Tchervenkov Balloon angioplasty in the treatment of aortic coarctation Ann. Thorac. Surg., September 1, 1992; 54(3): 599 - 600. [PDF]
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R. D. Siewers, J. Ettedgui, E. Pahl, T. Tallman, and P. J. del Nido Coarctation and hypoplasia of the aortic arch: Will the arch grow? Ann. Thorac. Surg., September 1, 1991; 52(3): 608 - 613. [Abstract] [PDF]
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J. A. M. van Son, L. K. Lacquet, and J. G. Vincent Risk of reintervention after coarctation repair Ann. Thorac. Surg., March 1, 1991; 51(3): 521 - 521. [PDF]
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I. L. Kron, T. L. Flanagan, K. S. Rheuban, M. A. Carpenter, H. P. Gutgesell Jr, L. H. Blackbourne, and S. P. Nolan Incidence and risk of reintervention after coarctation repair Ann. Thorac. Surg., June 1, 1990; 49(6): 920 - 926. [Abstract] [PDF]
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