Single-stage repair of aortic coarctation and multiple concomitant cardiac lesions through a median sternotomy

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Disease
• Surgical Innovation

Background:

• Complex congenital heart disease often requires multi-stage interventions.
• Aortic coarctation, ventricular septal defect, patent foramen ovale, and mitral valve insufficiency present significant surgical challenges.
• Minimizing cardiopulmonary bypass and aortic cross-clamp times is crucial for patient outcomes.

Observation:

• A 38-year-old male patient presented with severe aortic coarctation, ventricular septal defect, patent foramen ovale, and mitral valve insufficiency.
• A median sternotomy approach was utilized for surgical intervention.

Findings:

• A successful single-stage repair was achieved for all diagnosed cardiac anomalies.
• Severe aortic coarctation was repaired using a synthetic graft between the ascending and descending aorta.
• The aortic coarctation repair was performed first, before aortic cross-clamping, to reduce overall cross-clamp duration.

Implications:

• This single-stage approach offers a potentially more efficient treatment strategy for complex congenital heart disease.
• Prioritizing aortic coarctation repair prior to cross-clamping may improve safety and reduce ischemia time.
• Further research can explore the long-term efficacy and applicability of this technique in similar patient populations.