[2 cases of prosthetic tubes in left pathway obstructions]

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Severe left ventricular outflow tract obstruction (LVOTO) presents complex surgical challenges in pediatric patients.
• Hypoplasia of the descending aorta and aortic ring are critical forms of LVOTO requiring innovative surgical solutions.

Observation:

• Two pediatric cases of severe LVOTO were managed using prosthetic tube grafts.
• Case 1: A 6-year-old with diffuse descending aorta hypoplasia underwent aortic arch to distal aorta grafting via thoracotomy.
• Case 2: A 3.5-year-old with aortic ring hypoplasia received a prosthetic tube with an aortic valve from the left ventricular apex to the abdominal aorta.

Findings:

• Both patients demonstrated good clinical and angiographic results one year post-surgery.
• The extra-cardiac prosthetic tube approach proved simple, non-traumatic, and effective for these complex pediatric cardiac lesions.

Implications:

• This surgical technique offers a viable, less invasive alternative for treating complex LVOTO in children.
• The described method avoids direct cardiac manipulation, potentially reducing operative risks and improving outcomes in pediatric cardiovascular surgery.