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Modified technique for coarctation of aorta with hypoplastic distal aortic arch
Author(s) -
Kozyrev Ivan A.,
Kotin Nikolai A.,
Averkin Igor I.,
Ivanov Andrey A.,
Latypov Alexander A.,
Gordeev Mikhail L.,
Vasichkina Elena S.,
Pervunina Tatyana M.,
Grekhov Evgeny V.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15492
Subject(s) - medicine , aortic arch , hypoplasia , arch , aorta , coarctation of the aorta , descending aorta , anastomosis , hypoplastic left heart syndrome , cardiology , concomitant , elephant trunks , surgery , heart disease , civil engineering , engineering
Background A combination of coarctation of aorta with various severity of distal arch hypoplasia frequently occurs in newborns. Traditional techniques in the neonatal period such as extended end‐to‐end anastomosis or inner curve patch are controversial. Arch geometry has a marked role in long‐term outcomes. We introduce a modified Amato technique of distal aortic arch enlargement with native tissue‐to‐tissue reconstruction. Methods Neonatal patients with coarctation of aorta and distal aortic arch hypoplasia who underwent surgical reconstruction using this technique between January 2016 and December 2019 in our center were included. Patients with concomitant complex heart defects were excluded. Data were obtained from echo protocols, CT scans before and after repair. The dimensions of the arch were assessed using Z ‐score, arch geometry was evaluated with height/width ratio. Results Thirty‐two patients (22 males, 10 females) were included. Median age and weight were 7 days (5; 18) and 3.5 kg (3.1; 4.0), respectively. The Z ‐score of distal part of the arch before and after procedure was significantly different (<0.01). No mortality, recoarctation, or bronchial compression was found during 18 (6–38) months of follow‐up. Conclusion Modified technique for coarctation of aorta with hypoplastic distal aortic arch provides favorable geometry of the aorta with a low risk of morbidity. The proper selection and accurate technique could minimize potential risks. This method is relatively safe and might improve long‐term outcomes associated with the geometry of aorta.