Ross-Konno for Interrupted Aortic Arch: Simplified Arch Reconstruction Using Swing-Back Technique

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease
• Neonatal Cardiology

Background:

• Interrupted aortic arch and severe left ventricular outflow tract obstruction require complete relief and adequate aortic arch repair in neonates.
• The neonatal Ross-Konno procedure has demonstrated durable relief of left ventricular outflow tract gradients.
• Aortic arch reconstruction is critical for hemodynamics in neonates with these conditions.

Observation:

• The swing-back technique offers a simplified approach to aortic arch reconstruction.
• This technique facilitates a tension-free, direct anastomosis.
• Combined Ross-Konno and swing-back techniques were applied in three neonates.

Findings:

• The combined surgical technique successfully addressed both left ventricular outflow tract obstruction and aortic arch anomalies.
• The approach provided adequate and durable relief of left ventricular outflow tract gradients.
• Postoperative outcomes in the three neonates were favorable, demonstrating the efficacy of the technique.

Implications:

• This surgical strategy may represent an effective option for neonates with complex interrupted aortic arch and severe left ventricular outflow tract obstruction.
• Further studies are warranted to evaluate the long-term durability and broader applicability of this combined approach.
• The simplified reconstruction technique could potentially reduce operative complexity and improve outcomes in neonatal cardiac surgery.