Carlos M. Mery, MD, MPH, Francisco A. Guzmán-Pruneda, MD, Jeffrey G

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Presentation transcript:

Contemporary Results of Aortic Coarctation Repair Through Left Thoracotomy Carlos M. Mery, MD, MPH, Francisco A. Guzmán-Pruneda, MD, Jeffrey G. Trost, BS, Ericka McLaughlin, DO, Brendan M. Smith, MD, Dhaval R. Parekh, MD, Iki Adachi, MD, Jeffrey S. Heinle, MD, E. Dean McKenzie, MD, Charles D. Fraser, MD The Annals of Thoracic Surgery Volume 100, Issue 3, Pages 1039-1046 (September 2015) DOI: 10.1016/j.athoracsur.2015.04.129 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Surgical technique for (A) extended end-to-end anastomosis and (B) end-to-end anastomosis. After mobilization of the aorta, the ductus arteriosus (or ligamentum arteriosum) is dissected and divided. For an extended end-to-end repair, a cross-clamp is placed across the brachiocephalic vessels and the aortic arch leaving the innominate artery (and sometimes the left carotid artery) open while a second clamp is placed on the descending thoracic aorta. The ductal tissue is excised and the incision is extended proximally and distally. A wide spatulated anastomosis is performed between the aortic arch and the descending thoracic aorta. For simple end-to-end anastomosis, the clamps are placed above and below the site of coarctation, the coarctation and ductal tissue are excised, and an end-to-end anastomosis is performed. (Ao = aorta; CoA = coarctation of the aorta; PDA = patent ductus arteriosus; PA: pulmonary artery.) (Reproduced with permission from Texas Children’s Hospital, Houston, TX.) The Annals of Thoracic Surgery 2015 100, 1039-1046DOI: (10.1016/j.athoracsur.2015.04.129) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Kaplan-Meier curves for freedom from reintervention for neonates, infants, and older children. The Annals of Thoracic Surgery 2015 100, 1039-1046DOI: (10.1016/j.athoracsur.2015.04.129) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions