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Thorac Cardiovasc Surg 2012; 60(03): 221-225
DOI: 10.1055/s-0031-1298065
Original Cardiovascular
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Modified Repair of Interrupted Aortic Arch Utilizing Retroesophageal Right Subclavian Artery Based on a Neonatal Hybrid Approach in Hypoplastic Left Heart Complex

Klaus Valeske
1   Department of Pediatric Cardiac Surgery, Childrens Heart Center, Giessen, Germany
,
Matthias Mueller
2   Department for Anesthesiology, Childrens Heart Center, Giessen, Germany
,
Nizar Hijjeh
1   Department of Pediatric Cardiac Surgery, Childrens Heart Center, Giessen, Germany
,
Andreas Boening
1   Department of Pediatric Cardiac Surgery, Childrens Heart Center, Giessen, Germany
,
Dietmar Schranz
3   Department of Pediatric Cardiology, Childrens Heart Center, Giessen, Germany
,
Hakan Akintuerk
1   Department of Pediatric Cardiac Surgery, Childrens Heart Center, Giessen, Germany
› Author Affiliations
Further Information

Publication History

21 July 2011

05 September 2011

Publication Date:
05 January 2012 (online)

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Abstract

Objective Interrupted aortic arch (IAA) combined with an aberrant right subclavian artery (ARSA) is frequently associated with a hypoplastic ascending aorta. Neonatal surgical therapy carries a high risk particularly for aortic arch obstructions during the further follow-up.

Methods We performed a modified reconstruction of the aortic arch utilizing the ARSA as a natural substitute in a staged surgical approach. In a novel approach, the distal part of the ARSA is reimplanted into the brachiocephalic trunk.

Results In three patients, a novel arch reconstruction was successfully performed during complete biventricular repair. In a follow-up of 60 to 87 months, the reconstructed aortic arch has grown without any signs of obstruction in all three patients.

Conclusion Utilizing the ARSA for surgical aortic arch repair is a satisfactory solution, when postnatal borderline left heart obstruction associated with IAA and ARSA is postponed by an initial hybrid approach.

Keywords

congenital heart disease - CHD - imaging (all modalities) - pediatric
 

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