Interruption of the aortic arch: experience in 17 infants

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Defects
• Aortic Arch Anomalies

Background:

• Interruption of the aortic arch is a critical congenital heart defect.
• Early diagnosis and surgical intervention are crucial for survival.
• Associated intracardiac anomalies are common in patients with aortic arch interruption.

Purpose of the Study:

• To review surgical outcomes for interruption of the aortic arch in pediatric patients.
• To evaluate the effectiveness of different surgical strategies, including primary repair and palliative procedures.
• To assess long-term survival rates following surgical management.

Main Methods:

• Retrospective review of 17 children with aortic arch interruption operated between 1965 and 1982.
• Classification of aortic arch interruption types (A, B, C).
• Description of surgical techniques: primary repair, subclavian artery-aorta anastomosis, Dacron/PTFE grafts, VSD closure, pulmonary artery banding.

Main Results:

• Eight type A, eight type B, and one type C interruption were identified.
• All patients except three had associated intracardiac anomalies.
• Initial palliative operations had a 71% survival rate (10/14).
• Long-term survival in the total series was 53% (9/17).

Conclusions:

• Surgical management of aortic arch interruption in children requires tailored strategies based on defect type and associated anomalies.
• Palliative procedures can improve short-term survival, with potential for subsequent definitive repair.
• Long-term survival rates highlight the complexity and challenges in managing this condition.