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Determinants of survival following repair of interrupted aortic arch in infancy

S A Qureshi1, B Maruszewski, R McKay

  • 1Department of Paediatric Cardiology and Cardiac Surgery, Royal Liverpool Children's Hospital, U.K.

International Journal of Cardiology
|March 1, 1990
PubMed

Insights

A two-stage repair for interrupted aortic arch (IAA) in infants is a viable alternative to single-stage correction. This approach, particularly palliative surgery followed by complete repair, improves survival rates for complex congenital heart defects.

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Defects
  • Vascular Surgery

Background:

  • Interrupted aortic arch (IAA) is a severe congenital heart defect requiring surgical intervention.
  • Management strategies for IAA have evolved, with a shift towards staged surgical approaches.
  • Infants with IAA often present with complex associated cardiac anomalies.

Purpose of the Study:

  • To evaluate the outcomes of surgical management for infants with interrupted aortic arch.
  • To compare the effectiveness of two-stage repair versus primary complete repair.
  • To identify factors associated with improved survival in IAA patients.

Main Methods:

  • Retrospective analysis of 26 infants with interrupted aortic arch treated between 1971 and 1987.
  • Surgical techniques included prosthetic conduit, direct anastomosis, subclavian artery use, and pulmonary trunk/arterial duct use.
  • Patients were categorized into two-stage palliative surgery (with or without pulmonary trunk banding) or primary complete repair groups.

Main Results:

  • Overall early mortality was 57%, with higher rates in complex defects and single-stage repairs.
  • Survival following first-stage palliative surgery for IAA with isolated ventricular septal defect was 64%.
  • Two-stage repair and earlier year of operation were associated with improved survival.

Conclusions:

  • A two-stage repair strategy for interrupted aortic arch offers a reasonable alternative to primary complete correction.
  • Staged surgical management leads to satisfactory subsequent repairs in the majority of cases.
  • The findings support the use of two-stage repair for improved outcomes in infants with IAA.

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