Ascending Aortic Slide for Interrupted Aortic Arch Repair

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Interrupted aortic arch repair presents anatomical challenges for achieving tension-free anastomosis.
• Unfavorable anatomy can lead to complications in neonatal and infant cardiac surgery.

Purpose of the Study:

• To describe an alternative surgical technique for interrupted aortic arch repair.
• To evaluate the safety and reproducibility of the ascending aorta sliding technique.

Main Methods:

• A novel technique involving splitting the ascending aorta and creating a leftward/posterior flap.
• Anastomosis of the flap to the distal arch to form a native tissue bridge.
• Reconstruction using a patch, suitable for biventricular or univentricular palliation.

Main Results:

• The technique was successfully applied in five neonates/infants with wide aortic gaps.
• The ascending aorta slide provided a tension-free native tissue bridge.
• The method offers potential for growth and serves as a scaffold for patch augmentation.

Conclusions:

• The ascending aorta slide is a safe and reproducible technique for interrupted aortic arch repair.
• This method facilitates tension-free reconstruction and supports long-term cardiac growth.
• It is a valuable option for both biventricular and univentricular heart palliation strategies.