HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hagop Hovaguimian V. Senthilnathan John P. Iguidbashian Albert Starr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hovaguimian, H. Articles by Starr, A. Search for Related Content PubMed PubMed Citation Articles by Hovaguimian, H. Articles by Starr, A.

Ann Thorac Surg 1998;65:1751-1754
© 1998 The Society of Thoracic Surgeons

---

Original articles: cardiovascular

Coarctation Repair: Modification of End-to-End Anastomosis With Subclavian Flap Angioplasty

^a Albert Starr Academic and Research Institute, Portland, Oregon, USA

Accepted for publication January 28, 1998.

Address reprint requests to Dr Senthilnathan, 10 First Main Rd, Sylvan Lodge Colony, Kilpauk, Chennai 600 010, India
e-mail: (sreesen{at}giasmd01.vsnl.net.in)

Background. Subclavian angioplasty and resection and end-to-end anastomosis for coarctation repair carry a substantial risk of recurrence of coarctation. The combined technique using both these methods has shown good results but requires a longer period of continuous cross-clamping of the aorta.

Methods. A modified technique using intermittent cross-clamping with a period of reperfusion between cross-clamping periods was used. After the end-to-end anastomosis the clamps are released for 10 minutes and reapplied to do the subclavian angioplasty. Between 1991 and 1996 this was done in 26 infants (mean age, 5 weeks; range, 1 day to 6 months; median, 3 weeks). Mean weight was 3.85 kg (range, 1.5 to 8.4 kg). Mean length of follow-up was 23 months. Twenty-two patients (85%) had associated anomalies, excluding patent ductus arteriosus, and 5 patients (19%) had another procedure performed at the same time.

Results. There was no mortality. The mean echocardiographic gradient was 4 mm Hg in the immediate postoperative period and 2.9 mm Hg during follow-up. Residual or recurrent coarctation as detected by significant echocardiography or blood pressure gradient did not develop in any infant.

Conclusions. This modified technique of anastomosis is an effective way of relieving coarctation with excellent intermediate-term results.

This article has been cited by other articles:

				A. K. Younoszai, V. M. Reddy, F. L. Hanley, and M. M. Brook Intermediate term follow-up of the end-to-side aortic anastomosis for coarctation of the aorta Ann. Thorac. Surg., November 1, 2002; 74(5): 1631 - 1634. [Abstract] [Full Text] [PDF]

				A. Giamberti, G. Pome, G. Butera, L. Rosti, A. Agnetti, and A. Frigiola Extended end-to-end anastomosis with modified reverse subclavian flap angioplasty Ann. Thorac. Surg., September 1, 2001; 72(3): 951 - 952. [Abstract] [Full Text] [PDF]

				I. S. Landsman and P. J. Davis Aortic Coarctation: Anesthetic Considerations Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 91 - 97. [Abstract] [PDF]

				J. A.M. van Son Repair of coarctation of the aorta Ann. Thorac. Surg., April 1, 1999; 67(4): 1212 - 1213. [Full Text] [PDF]