[Two-staged repair of coarctation of the aortic arch with severe subaortic stenosis and ventricular septal defect].

Y Shiina, H Kin, M Ogawa, M Mukaida, K Ishihara, K Kawazoe
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Abstract

Aortic arch coarctation proximal to the left subclavian artery is a rare anomaly. It is about 1% of all coarctation of the aorta. This 16 days neonate with coarctation of aortic arch with severe subaortic stenosis and ventricular septal defect was underwent two staged repair. In the first-stage operation, coarctation of the aortic arch was reconstructed by extended end to end direct anastomosis through posterolateral thoracotomy. In the second stage, we performed intracardiac repair with use of a technique which included resection of superior margin of conus septum through VSD and patch closure of VSD. The postoperative pressure study showed no gradient between left ventricle and left radial artery. The postoperative course was satisfactory. This patient is doing well.

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主动脉弓缩窄合并严重主动脉下狭窄和室间隔缺损的两阶段修复。
左锁骨下动脉近端主动脉弓缩窄是一种罕见的异常。约占所有主动脉缩窄的1%这16天的新生儿主动脉弓缩窄,严重的主动脉下狭窄和室间隔缺损进行了两个阶段的修复。一期手术通过后外侧开胸扩大端端直接吻合重建主动脉弓缩窄。在第二阶段,我们使用一种技术进行心内修复,包括通过VSD切除中隔圆锥上缘和VSD补片闭合。术后血压检查显示左心室和左桡动脉之间无梯度。术后疗程令人满意。这个病人情况很好。
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