Combined procedure using a double flap as a surgical option for coarctation of the aorta with delayed diagnosis
Mitsuru Sato1, Naoki Masaki1, Sadahiro Sai2
1Department of Cardiovascular Surgery, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai City, Miyagi, 989-3126, Japan.
Insights
This study presents a surgical technique for late-diagnosed coarctation of the aorta in children, minimizing synthetic graft use. The method aims for successful anatomical repair while reducing risks like limb ischemia and growth impairment.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Thoracic Surgery
Background:
- Coarctation of the aorta (CoA) is a congenital heart defect.
- Infantile CoA is typically repaired with direct anastomosis or subclavian flap aortoplasty.
- Late diagnosis in school-age children presents unique surgical challenges.
Purpose of the Study:
- To describe a surgical technique for late-diagnosed CoA in school-age patients.
- To minimize the use of synthetic graft materials in repair.
- To achieve successful anatomical repair while mitigating risks.
Main Methods:
- Describes a novel surgical approach for coarctation of the aorta in older children.
- Focuses on reducing reliance on synthetic materials.
- Emphasizes anatomical repair to avoid complications.
Main Results:
- Successful anatomical repair of coarctation of the aorta was achieved.
- Minimized use of synthetic graft material.
- Addressed risks associated with late repair, such as limb ischemia and growth concerns.
Conclusions:
- The described technique offers a viable option for late-diagnosed coarctation of the aorta.
- Minimizing synthetic material is crucial for long-term outcomes in pediatric patients.
- This approach balances effective repair with reduced surgical risks.
Abstract:
Simple coarctation of the aorta is repaired in an infant by direct end-to-end anastomosis of the aorta or subclavian flap aortoplasty. However, some cases are not detected until late childhood. For school-age patients, greater consideration must be given to risks such as postoperative limb ischemia and the potentially harmful effects of any artificial material on future growth. Here, we describe our technique for these patients, in whom the value of direct anastomosis is uncertain, to minimize the amount of synthetic graft material used while achieving successful anatomical repair.
