Staged surgical repair for infants with interrupted aortic arch
Journal
Asian Journal of Surgery
Journal Volume
43
Journal Issue
11
Pages
1074-1077
Date Issued
2020
Author(s)
Abstract
Background: Interrupted aortic arch (IAA) is a rare congenital cardiac anomaly, which necessitates surgical treatment. There are several surgical strategies for corrective repair of IAA, such as one-stage repair, rapid two-stage repair and two-stage repair. Here, we reported our surgical result of staged-repair policy for the patients with IAA. Method: From November 2003 to July 2015, there were 14 patients (8 boys, 6 girls) with IAA treated by us. Except one teenager patient, we routinely used intravenous infusion of prostaglandin E1 for all the infant patients (n = 13) to keep adequate end organ perfusion before the first surgical intervention. Surgical repair was performed after the perfusion of end organs recovered. Result: Two patients (1 teenager and 1 infant with one-stage surgery) were excluded from this study. At the time of the first surgery, we did the first-stage surgery with anastomosis in between aortic arch and descending aorta, division of patent ductus arteriosus and banding of pulmonary trunk through left thoracotomy. The overall surgical survival rate of the first surgery was 100% (12/12). At the time of the second surgery, corrective repair was done under cardiopulmonary bypass through median sternotomy. The surgical survival rate of the corrective surgery was also 100%. There is no late death during follow-up for 9 years (range 4.2–15.0 years). Conclusion: Out of several surgical strategies for the infants with IAA, staged repair still could be a treatment option to achieve satisfied surgical result. ? 2020
Subjects
Interrupted aortic arch; Staged surgical repair; Thoracotomy
SDGs
Other Subjects
prostaglandin E1; adolescent; age; cardiopulmonary bypass; cardiovascular surgery; congenital heart malformation; female; follow up; human; infant; intravenous drug administration; male; mortality; newborn; preoperative care; procedures; reoperation; sternotomy; survival rate; thoracic aorta; time factor; treatment outcome; Adolescent; Age Factors; Alprostadil; Aorta, Thoracic; Cardiopulmonary Bypass; Cardiovascular Surgical Procedures; Female; Follow-Up Studies; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Infusions, Intravenous; Male; Preoperative Care; Reoperation; Sternotomy; Survival Rate; Time Factors; Treatment Outcome
Publisher
Elsevier (Singapore) Pte Ltd
Type
journal article