Open-Hybrid Aortic Stent Placement for Recurrent Coarctation in Complex Single Ventricles

Andrew K. Morse BS , Blaz Podgorsek MD , Julija Dobrila MD , Zachary A. Cerra MD , Kiran K. Mallula MD, MS , Muhammad S. Khan MD , Christopher E. Greenleaf MD, MBA , Jorge D. Salazar MD , Damien J. LaPar MD, MSc , Peter C. Chen MD
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Abstract

Recurrent coarctation of the aorta in patients with hypoplastic left heart syndrome requires timely intervention to limit ventricular dysfunction and atrioventricular valve regurgitation. Current strategies include catheter-based intervention in adequately sized patients or surgical arch augmentation at the time of a concomitant operation. We report an open-hybrid surgical technique with placement of a balloon-expandable stent that can later be expanded to an adult size as the patient grows. Limiting the arch dissection reduces the risk to the left recurrent laryngeal nerve and shortens anterograde cerebral perfusion time.
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开放式-混合型主动脉支架置入治疗复杂单心室复发性缩窄
左心发育不全综合征患者复发性主动脉缩窄需要及时干预,以限制心室功能障碍和房室瓣膜返流。目前的策略包括在适当大小的患者中进行导管干预或在合并手术时进行外科弓增强。我们报告了一种开放混合手术技术,放置一个可膨胀的球囊支架,随着患者的生长,该支架可以扩展到成人的大小。限制足弓剥离可减少左喉返神经的危险,缩短顺行脑灌注时间。
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