Surgical management of aortic arch obstruction associated with intracardiac anomalies in children / 中国医师杂志

Objective To summarize the clinical experience in repair of aortic arch obstruction associated with intracardiac anomalies in children retrospectively.Methods From March 2010 to March 2014,73 children diagnosed as coarctation of the aorta (CoA,n =68),interrupted aortic arch (IAA,n =3),and double aortic arch with CoA (n =2) underwent surgical management.Six of them were complicated with complex intracardiac anmalies,including tetralogy of Fallot (TOF,n =2),transposition of great arteries (TGA,n =1),total anomalous pulmonary venous connection (TAPVC,n =1),double outlet of right ventricle (DORV,n =1),and Shone's syndrome (n =1) ; the rest 67 patients were associated with ventricular septal defect (VSD) and other simple anomalies.Twenty eight cases had hypoplasia of the aortic arch.All the patients had one-stage repair except for one.The aortic arch reconstruction was end to end anastomosis between the descending aorta and the arch in 42 patients,end to side anastomosis in 22,and the aortic arch were enlarged using autologous pulmonary artery patch in 9.The associated intracardiac anomalies were repaired in the same stage.Results There were 2 deaths.The operative mortality was 2.7％.Renal failure was occurred in 2 cases who were cured afterwards by peritoneal dialysis.All survivors were followed up for 3 ～ 36 months,anastomotic restenosis was found in 1 case who underwent reoperation 14 months after the first operation.No neurological complications were occurred.Conclusions One-stage complete correction of CoA and IAA with intracardiac anomalies through median sternotomy can achieve excellent short-and mid-term surgical results.