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Modified technique for uncommon coarctation of the aorta with arch hypoplasia


1 Department of Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
2 Department of Cardiac Anesthesia, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
3 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

Correspondence Address:
Dr. Brijesh Parayaru Kottayil
Department of Cardiothoracic Surgery, Amrita Institute of Medical Science and Research Centre, Ponekkara, Kochi, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_34_18

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Year : 2018  |  Volume : 11  |  Issue : 3  |  Page : 275-277

 

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A true presubclavian coarctation of the aorta with arch hypoplasia without major intracardiac anomaly can result in a surgical dilemma. Theoretically, one can avoid repair through median sternotomy using selective cerebral perfusion and its sequelae since no major intracardiac repair is needed. Repair through thoracotomy is technically challenging if arch reconstruction is required and precise surgical planning is required to avoid spinal hypoperfusion and to maintain cerebral perfusion. Moreover, inadequate repair often has resulted in hypoplastic aortic arch or residual coarctation on follow-up requiring future intervention. We have employed a modified surgical repair through thoracotomy avoiding cardiopulmonary bypass to address presubclavian coarctation of the aorta with diffuse arch hypoplasia with theoretically less chance for future stenosis.






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1 Department of Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
2 Department of Cardiac Anesthesia, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
3 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

Correspondence Address:
Dr. Brijesh Parayaru Kottayil
Department of Cardiothoracic Surgery, Amrita Institute of Medical Science and Research Centre, Ponekkara, Kochi, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_34_18

Rights and Permissions

A true presubclavian coarctation of the aorta with arch hypoplasia without major intracardiac anomaly can result in a surgical dilemma. Theoretically, one can avoid repair through median sternotomy using selective cerebral perfusion and its sequelae since no major intracardiac repair is needed. Repair through thoracotomy is technically challenging if arch reconstruction is required and precise surgical planning is required to avoid spinal hypoperfusion and to maintain cerebral perfusion. Moreover, inadequate repair often has resulted in hypoplastic aortic arch or residual coarctation on follow-up requiring future intervention. We have employed a modified surgical repair through thoracotomy avoiding cardiopulmonary bypass to address presubclavian coarctation of the aorta with diffuse arch hypoplasia with theoretically less chance for future stenosis.






[FULL TEXT] [PDF]*


        
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