Beating-Heart Sliding Arch Aortoplasty for Arch Hypoplasia Beyond Infancy

Hypoplasia of the aortic arch commonly accompanies coarctation of the aorta and should be addressed at the time of coarctation repair to prevent residual gradient. Using a novel technique, McKenzie et al performed an ascending sliding arch aortoplasty to correct hypoplasia using native aortic tissue. This procedure was accomplished with an arrested heart and uses the fact that the ascending aorta associated with the hypoplastic arch is typically elongated. We have furthered the development of the ascending sliding arch aortoplasty by performing the entire procedure without inducing cardiac arrest.