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Correction of interrupted aortic arch.

J L Monro1, R W Bunton, G R Sutherland

  • 1Department of Cardiac Surgery, General Hospital, Southampton, England.

The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1989
PubMed
Summary
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This study shows that repairing interrupted aortic arch, ventricular septal defect, and persistent ductus arteriosus without synthetic grafts is effective. Ten survivors demonstrate the viability of this surgical approach for complex congenital heart defects.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Thoracic Surgery

Background:

  • Interrupted aortic arch (IAA) is a rare and severe congenital heart defect.
  • Associated anomalies like ventricular septal defect (VSD) and persistent ductus arteriosus (PDA) complicate surgical repair.
  • Synthetic grafts are often used in complex aortic arch reconstruction.

Purpose of the Study:

  • To evaluate the efficacy of complete surgical repair of IAA, VSD, and PDA without using synthetic grafts.
  • To assess the long-term outcomes of this graftless approach in infants.

Main Methods:

  • Retrospective analysis of twelve consecutive infants with IAA, VSD, and PDA.
  • Surgical repair techniques included using the ductus arteriosus, left carotid artery, or direct anastomosis.

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  • No synthetic grafts were employed in any of the repairs.

    • Main Results:

    • Ten out of twelve infants survived with a mean follow-up of 5 years.
    • Two infants required reoperation for anastomosis stenosis, resulting in one death.
    • Associated conditions included persistent truncus arteriosus in two patients.

    Conclusions:

    • Complete repair of interrupted aortic arch, ventricular septal defect, and persistent ductus arteriosus without synthetic grafts is a viable and effective treatment.
    • This graftless approach offers a favorable outcome for selected infants with complex congenital heart disease.
    • The study supports the graftless repair as the treatment of choice for this rare condition.