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Single-stage surgical correction of combination lesions through thoracotomy
Sowmya Ramanan1, Navaneetha Sasikumar, Kizakke K Pradeep
1Department of Pediatric Cardiac Surgery and Cardiology, Frontier Lifeline Hospital, Chennai, Tamil Nadu, India.
Insights
This case report details the successful surgical repair of coarctation of the aorta (COA) and partial anomalous pulmonary venous drainage through a single left thoracotomy incision, highlighting an alternative approach for complex congenital heart disease.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Thoracic Surgery
Background:
- Coarctation of the aorta (COA) frequently coexists with other cardiac anomalies, complicating surgical management.
- Median sternotomy is typically required for complex COA repairs, limiting minimally invasive options.
- Lesions amenable to thoracotomy are rarely associated with COA.
Observation:
- A 13-year-old male presented with coarctation of the descending aorta.
- The patient also had partial anomalous pulmonary venous drainage of the left upper pulmonary vein into the innominate vein.
- Both conditions required surgical intervention.
Findings:
- Simultaneous surgical correction of COA and partial anomalous pulmonary venous drainage was performed.
- A left thoracotomy incision was utilized for the repair.
- This approach facilitated the management of both congenital heart defects.
Implications:
- Demonstrates the feasibility of repairing complex COA with associated anomalies via thoracotomy.
- Suggests thoracotomy as a viable alternative to sternotomy in select cases.
- Offers potential for less invasive surgical treatment of combined cardiac lesions.
Abstract:
Coarctation of the descending aorta is associated with significant cardiac lesions in up to 50% of the patients. Under such circumstances, surgical management requires consideration of the nature of the associated lesion which usually requires a median sternotomy for surgical correction. Coarctation of the aorta (COA) is, therefore, rarely associated with lesions that are amenable to surgical correction through a thoracotomy incision. In this case report, we report a case of COA with significant associated cardiac disease that was repaired through a left thoracotomy incision. A 13-year-old boy was found to have COA and also partial anomalous pulmonary venous drainage of the left upper pulmonary vein to the innominate vein. Both the lesions were surgically corrected simultaneously through a thoracotomy.
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