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J Thorac Cardiovasc Surg 2006;132:967-968
© 2006 The American Association for Thoracic Surgery

Brief Communication

Left internal thoracic artery patch aortoplasty for repair of coarctation of the aorta

Vitaly Demyanchuk, MD, PhD*, Larysa Naumova, MD, PhD, Mykhaylo Atamanyuk, MD, PhD, Sergiy Dykukha, MD, PhD

Department of Congenital Heart Diseases, Mykola Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine.

Received for publication May 5, 2006; accepted for publication June 6, 2006.

* Address for reprints: Vitaly B. Demyanchuk, MD, PhD, Department of Congenital Heart Diseases, Mykola Amosov Institute of Cardiovascular Surgery, Amosova St, 6, 03680 Kyiv, Ukraine. (Email: v_tall_e@hotmail.com).

The first 20% of the full text of this article appears below.


Figure 1
Dr Demyanchuk


Adult patients with long coarctation of the aorta (CoA) may require coarctectomy and prosthetic tube or patch implantation. Potential drawbacks of these techniques, such as risk of infection, thrombosis, neointimal ingrowth, and aneurysm formation, are closely related to the use of prosthetic materials.1-3Go To avoid these specific risks, we developed a technique that includes resection of coarctation and two elements of plastic procedure: end-to-end suturing of the aorta posterior wall and patch closure of the longitudinally incised aorta anterior wall. The material for the patch is autologous left internal thoracic artery (LITA).

Technique

The approach is by left posterolateral thoracotomy through the fourth intercostal space. The length of the CoA and diameter of LITA are measured (Figure 1, A). If the LITA diameter is big enough, then a segment of this vessel is harvested within the area between the second and third intercostal spaces. The arterial cylinder is opened longitudinally to prepare a patch (Figure 1, B). After harvesting, the . . . [Full Text of this Article]






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