Surgical management of patients with interrupted aortic arch and severe subaortic stenosis. Ann Thorac Surg 1988 Feb;45(2):174-80
Date
02/01/1988Pubmed ID
2449143DOI
10.1016/s0003-4975(10)62432-0Scopus ID
2-s2.0-0023841370 (requires institutional sign-in at Scopus site) 41 CitationsAbstract
Ten patients underwent palliative surgery for interrupted aortic arch and severe subaortic obstruction due to posterior displacement of the conal septum. Their ages ranged between 4 and 28 days (mean, 11.0 +/- 7.7 days) and their weights, between 2.1 and 4.2 kg (mean, 2.85 +/- 0.6 kg). Preoperative echocardiography and cardiac catheterization were performed on all patients. The ratios of the left ventricular outflow tract diameters and the ascending aortic diameters to the descending aortic diameters were 0.56 +/- 0.03 and 0.56 +/- 0.06, respectively, compared with 0.81 +/- 0.12 and 0.95 +/- 0.17, respectively, in 20 patients with interrupted aortic arch but without obstruction (p less than 0.001). Four of the 10 patients underwent pulmonary artery banding and insertion of a bypass graft between the ascending and the descending aorta. All 4 died of low cardiac output soon after operation (100% operative mortality). The remaining 6 patients underwent banding and insertion of a graft between the main pulmonary artery proximal to the band, and the descending aorta. All of these patients survived, and all except 1 are doing well 3 months to 4 years postoperatively. The use of a pulmonary artery-descending aorta conduit and of distal pulmonary artery banding provides good palliation for patients with interrupted aortic arch and major subaortic stenosis.
Author List
Ilbawi MN, Idriss FS, DeLeon SY, Muster AJ, Benson DW Jr, Paul MHMESH terms used to index this publication - Major topics in bold
Aorta, ThoracicAortic Stenosis, Subvalvular
Blood Vessel Prosthesis
Cardiomyopathy, Hypertrophic
Follow-Up Studies
Heart Septal Defects, Ventricular
Humans
Infant, Newborn
Palliative Care
Postoperative Complications
Pulmonary Artery
Time Factors