Aortopulmonary Window and the Interrupted Aortic Arch: Midterm Results With Use of the Single-Patch Technique François Roubertie, MD, David Kalfa, MD,

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Presentation transcript:

Aortopulmonary Window and the Interrupted Aortic Arch: Midterm Results With Use of the Single-Patch Technique François Roubertie, MD, David Kalfa, MD, Mathieu Vergnat, MD, Mohamed Ly, MD, Virginie Lambert, MD, Emre Belli, MD The Annals of Thoracic Surgery Volume 99, Issue 1, Pages 186-191 (January 2015) DOI: 10.1016/j.athoracsur.2014.08.023 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The aortopulmonary window (dashed line) is associated with a type A interrupted aortic arch. The pulmonary artery trunk is dilated compared with the ascending aorta. A single aortic cannula is placed through a 3.5-mm polytetrafluoroethylene graft anastomosed to the right innominate artery. The Annals of Thoracic Surgery 2015 99, 186-191DOI: (10.1016/j.athoracsur.2014.08.023) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The arch vessels are occluded with snares after selective cerebral perfusion is performed. The aortopulmonary window is opened and the incision is continued on to the ascending aorta and aortic arch (dashed line). The Annals of Thoracic Surgery 2015 99, 186-191DOI: (10.1016/j.athoracsur.2014.08.023) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A partial anastomosis is carried out between the descending aorta and the aortic arch; then, an incision (1.5 cm long) is made on the descending aorta. The Annals of Thoracic Surgery 2015 99, 186-191DOI: (10.1016/j.athoracsur.2014.08.023) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 An autologous pericardial patch is used to enlarge the descending aorta, the arch concavity, and the ascending aorta. When the suture reaches the anterior–superior edge of the aortopulmonary window, a continuous mattress suture incorporates the wall of the pulmonary artery, the patch, and the aortic wall (the “sandwich” patch technique, used to close the aortopulmonary window, can be seen in the magnified insert). (Ant = anterior part of the aortopulmonary window in the magnified insert; Post = posterior part of the aortopulmonary window in the magnified insert.) The Annals of Thoracic Surgery 2015 99, 186-191DOI: (10.1016/j.athoracsur.2014.08.023) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions