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Interrupted aortic arch

M H Zou, L Ma, Y S Xia, S C Yang, W D Chen, F Cao, X X Chen
Objective: To review the early and mid-term results of end-to-side anastomosis technique for interrupted aortic arch in neonates and infants. Methods: Clinic data of 46 patients were diagnosed as interrupted aortic arch in Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center between January 2010 and December 2016 were analyzed retrospectively. Twenty-six cases were neonates. The median age underwent surgery was 23 days (range: 2 days to 8 years). Anatomical subtypes included 36 cases of type A and 10 cases of type B...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Ginnie Abarbanell, William L Border, Brian Schlosser, Gemma Morrow, Michael Kelleman, Ritu Sachdeva
OBJECTIVE: It is unclear whether neonates with interrupted aortic arch (IAA) and a smaller left ventricular outflow tract may have improved outcomes with a Yasui operation (ventricular outflow bypass procedure) over a primary complete repair. This study sought to identify preoperative echocardiographic parameters to differentiate which neonates may have improved outcomes with a primary vs Yasui operation. DESIGN: Patient demographics, cardiac surgery type, complications, need for reoperation and/or interventional catheterization, and date of last follow-up were collected on neonates who underwent a biventricular repair for IAA from 2003 to 2014...
March 9, 2018: Congenital Heart Disease
Melissa G Y Lee, Johnny Millar, Elizabeth Rose, Aleesha Jones, Dora Wood, Taryn L Luitingh, Diana Zannino, Johann Brink, Igor E Konstantinov, Christian P Brizard, Yves d'Udekem
OBJECTIVES: To determine the incidence of vocal cord paresis (VCP) after neonatal aortic arch repair/Norwood-type procedure, and the effectiveness of noninvasive laryngeal ultrasound in detecting VCP compared with gold standard invasive nasoendoscopy. METHODS: Fifty-two patients who underwent an arch repair (39 of 52; 75%) or Norwood-type procedure (13 of 52; 25%) via sternotomy between April 1, 2015, and April 30, 2017 underwent laryngeal ultrasound (50 of 52; 96%) and/or flexible fiber optic nasoendoscopy (39 of 52; 75%) at 48 to 72 hours after endotracheal extubation...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Giuseppe Antonio Mazza, Gaetana Ferraro, Gabriella Agnoletti
Aortic arch interruption or atresia consists in a complete loss of anatomical and luminal continuity between the ascending and descending thoracic aorta. It is usually diagnosed in newborn babies but may also be present in young children, adolescents, adults and elderly patients. In these cases, it can be congenital or more frequently acquired. This latter type of aortic arch atresia is a challenge, and surgery is usually the treatment of choice. Percutaneous approaches are also possible today. We describe a case of percutaneous aortic arch reconstruction in a 9-year-old boy...
February 28, 2018: Cardiovascular and Interventional Radiology
Eva Kapravelou, David Anderson, Gareth J Morgan
The use of hybrid techniques to avoid neonatal cardiopulmonary bypass in high-risk individuals is well reported in the setting of hypoplastic left heart syndrome. We describe the use of that technique as a bridging procedure in high-risk neonates with an interrupted aortic arch. We report three cases where hybrid branch pulmonary artery banding and ductal stent implantation has been successfully used to defer complete repair, allowing recovery, maturity, and weight gain. This strategy may be considered for patients deemed at high risk for primary neonatal repair...
March 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Mohammed Mohsin Uzzaman, Natasha E Khan, Ben Davies, John Stickley, Timothy J Jones, William J Brawn, David J Barron
BACKGROUND: We analysed outcomes of IAA repair using a standardised technique in order to interpret the role of the arch repair on late outcomes in this complex and heterogeneous group. METHODS: Single institution study from 1988-2015. 120 cases of IAA were divided into four groups: IAA with VSD (iVSD, n=38), IAA with Norwood/DKS (iNor, n=41), IAA with Truncus (iTruncus, n=24) and miscellaneous group (iMisc, n=17). Arch repair performed using a standard technique of direct anastomosis with homograft patch augmentation...
February 13, 2018: Annals of Thoracic Surgery
Ali Dodge-Khatami
No abstract text is available yet for this article.
January 2018: Translational Pediatrics
Pradeep Vaideeswar, Supreet Marathe, Saranya Singaravel, Robert H Anderson
Congenital aortic anomalies are uncommon causes of secondary hypertension and are seldom suspected in the adult age group. We present a case of aortic interruption unexpectedly diagnosed on autopsy in a 38-year-old male who presented with cardiovascular collapse. Apart from interruption, a finding unique to our case was aneurysmal dilation of the proximal descending aorta just before the obstruction with thrombosis. We also attempt to review the literature for interrupted aortic arch in adults and clarify the nomenclature of interruption versus coarctation...
January 2018: Annals of Pediatric Cardiology
Laurent Van Camp, Werner Budts, Geert Maleux
An adolescent patient with a previous history of surgical repair for interrupted aortic arch type B presented with an asymptomatic, saccular pseudoaneurysm of the proximal, common left carotid artery, identified on a follow-up magnetic resonance angiography of the thoracic large vessels. The pseudoaneurysm was successfully excluded with a covered stent. Clinical and radiological follow-up after 2 years was uneventful.
January 2018: Annals of Pediatric Cardiology
Xin Zhang, Xiao-Wei Liu, Xiao-Yan Gu, Jian-Cheng Han, Xiao-Yan Hao, Yu-Wei Fu, Yi-Hua He
Berry syndrome is a rare congenital cardiac malformation. We describe 4 cases of Berry syndrome diagnosed by fetal echocardiography. Based on our experience, the three-vessel view is important for diagnosing the aortopulmonary window and aortic origin of the right pulmonary artery. Furthermore, the true cross-sectional and sagittal views obtained by continuously scanning from the three-vessel-trachea view to the long-axis view of the aortic arch are required to image the interruption or coarctation of the aortic arch...
February 11, 2018: Echocardiography
Mousam Dey, Naveen Garg, Sunil Kumar
Interrupted aortic arch is a rare congenital anomaly in newborns and infants and is commonly associated with other cardiovascular anomalies. Here, we report an unusual case of type A interrupted cervical aortic arch associated with long segment coarctation of the descending thoracic aorta. Patent ductus arteriosus reconstituted the descending thoracic aorta. Proximal segments of the left common carotid and left subclavian arteries were atretic. Echocardiography-gated multidetector CT angiography not only identified the type of aortic arch interruption in the neonate but also delineated the exact anatomical details...
February 9, 2018: Cardiology in the Young
Akihiko Higashida, Takaya Hoashi, Masataka Kitano, Masatoshi Shimada, Tomohiro Nakata, Hideto Ozawa, Kenichi Kurosaki, Hajime Ichikawa
OBJECTIVES: To assess the feasibility of hybrid Stage I palliation consisting of bilateral pulmonary artery bandings and ductal stenting for patients with 2 ventricular cavities and hypoplastic left heart structures. METHODS: Eleven consecutive patients who underwent hybrid Stage I palliation between 2010 and 2017 were enrolled. The diagnoses were interrupted aortic arch/coarctation of the aorta, ventricular septal defect and significant left ventricular (LV) outflow tract obstruction in 5 patients, critical aortic stenosis and reduced LV contraction in 3 patients and hypoplastic left heart complex in 3 patients...
January 24, 2018: Interactive Cardiovascular and Thoracic Surgery
Ryan E Accord, Paul Schoof, Gregor Krings, Felix Haas
In neonates with interrupted aortic arch and severe left ventricular outflow tract obstruction full relief of left ventricular outflow tract obstruction and adequate aortic arch repair is required. It has been shown that neonatal Ross-Konno provides adequate and durable relieve of left ventricular outflow tract gradient. Additional aortic arch repair using the swing-back technique provides a simplified reconstruction of the arch with a tension-free, direct anastomosis. We describe the technique and results of our experience in 3 neonates...
February 2018: Annals of Thoracic Surgery
Yasuhiro Hirano, Noboru Inamura, Yukiko Kawazu, Hisaaki Aoki, Futoshi Kayatani, Shigemitsu Iwai, Hiroaki Kawata
BACKGROUND: At our institution, we perform bilateral pulmonary artery banding (BPAB) as the first-stage palliation for interrupted aortic arch (IAA) with low birth weight or severe subaortic stenosis (SAS). The present study aimed to identify factors that may influence the decision regarding the type of second-stage operation, that is, univentricular palliation or biventricular repair, in these patients. METHODS: Cardiac catheterization and angiographic data of nine patients with IAA who underwent initial BPAB and subsequent univentricular or biventricular repair were retrospectively analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
Karl Reyes, Mohsen Ahmed, Alan Brock, Mark Bleiweis
Truncus arteriosus is an extremely rare and complex form of congenital heart disease. Surgical strategies vary depending on anatomic subtype.  In this tutorial, we present our surgical technique for single stage repair of a truncus arteriosus with interrupted aortic arch (Van Praagh type A4).
December 12, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Amer Harky, Matthew Fok, Mohamad Bashir, Anthony L Estrera
During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery...
January 3, 2018: General Thoracic and Cardiovascular Surgery
Joshua A Kailin, Alexia B Santos, Betul Yilmaz Furtun, S Kristen Sexson Tejtel, Regina Lantin-Hermoso
Isolated coarctation of the aorta (CoA) is estimated by the Centers for Disease Control and Prevention to account for 4%-6% of all congenital heart disease (CHD) in the United States, with a reported prevalence of ~4 per 10 000 live births. Prenatal recognition of coarctation is important as it may improve neonatal survival and reduce morbidity. However, despite advances in imaging and the trend toward detailed aortic arch assessment as part of a comprehensive fetal echocardiogram, isolated CoA may still elude prenatal detection, with potentially lethal consequences if the diagnosis is not suspected and the patent ductus arteriosus (PDA) closes spontaneously in postnatal life...
December 2017: Echocardiography
Tingting Man, Yihua He, Ying Zhao, Lin Sun, Xiaowei Liu, Shuping Ge
BACKGROUND AND OBJECTIVE: It is hypothesized that diminished cerebral vascular resistance or the "brain sparing effect" is associated with fetuses with complex congenital heart defects (CHD) and may affect their neurodevelopmental outcome. An alternative explanation is that it is related to the location, cardiac output, pressure, and resistance in left heart obstructive CHDs. We sought to determine the effects of various left and right heart obstructive defects on the cerebral and placental hemodynamics and to evaluate the utility of these variables for the assessment and prognosis of CHDs...
December 2017: Echocardiography
Selman Vefa Yıldırım, Ali Yıldırım
Yıldırım SV, Yıldırım A. Truncus arteriosus with double aortic arch: A rare association. Turk J Pediatr 2017; 59: 221-223. Truncus arteriosus (TA) is a congenital heart defect often diagnosed in neonatal period; it represents 0.7% of all congenital heart lesions. The pulmonary arteries originate generally above the coronary ostium. Aorto-pulmonary and interventricular defects are believed to represent an abnormality of conotruncal septation. TA is classified into four types, according to Van Praagh and Colette Edwards...
2017: Turkish Journal of Pediatrics
Jian Mei Zhou, Xin Wen Liu, Yi Yang, Bo Zhong Wang, Jian An Wang
RATIONALE: Though it is rare, isolated interrupted aortic arch (IAA) could lead to hypertension. Surgical repair is the only effective curative method to treat IAA conditions and patients with IAA can hardly survive to adulthood with medication alone. We report an IAA case that of a 45-year-old male patient who survived for 45 years without surgical treatment. PATIENT CONCERNS: A 45-year-old man was referred to the hospital presenting with abnormal blood pressure level...
December 2017: Medicine (Baltimore)
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