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Subclavian flap aortoplasty and preservation of left upper extremity circulation using an interposition graft
Khalil Zarrabi1, Fariborz Ghaffarpasand, Nima Zamiri
1Department of Cardiothoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Objectives:
To introduce a surgical technique to maintain left upper limb blood flow after subclavian flap aortoplasty (SFA).
Methods:
Five patients (9 to 23 months of age) with a diagnosis of long-segment aortic coarctation underwent conventional SFA. A Gore-tex graft was interposed between the stump and the proximal descending aorta to maintain perfusion of subclavian artery.
Results:
All patients had a patent Gore-tex graft and normal blood flow of the subclavian artery and left upper limb. One patient expired and four others were discharged with a mean follow-up of 48 months. On follow-up all patients had normal development of the left upper limb and no signs of limb ischemia. Echo findings revealed normal arch flow with normal flow in the Gore-tex graft and left upper extremity.
Conclusions:
Interposing a Gore-tex graft between the subclavian artery stump and proximal descending aorta concomitant with SFA can be safely performed in infants with long-segment aortic coarctation, with preservation of left upper extremity circulation.