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Ann Thorac Surg 2003;76:1728-1730
© 2003 The Society of Thoracic Surgeons

Case report

New "right side median" approach for postoperative re-coarctation of the aorta

Takeshi Shinkawa, MDa, Masaaki Yamagishi, MD*a, Keisuke Shuntoh, MDa, Tsutomu Matsushita, MDa, Katsuji Fujiwara, MDa, Nobuo Kitamura, MDa

a Department of Pediatric Cardiovascular Surgery, Children’s Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan

Accepted for publication March 28, 2003.

* Address reprint requests to Dr Yamagishi, Department of Pediatric Cardiovascular Surgery, Children’s Research Hospital, Kyoto Prefectural University of Medicine, Kawaramachi, Hirokoji, Kamikyo-ku, Kyoto 602-8566, Japan
e-mail: myama{at}koto.kpu-m.ac.jp

Anatomic repair of postoperative recurrent coarctation of the aorta is surgically difficult using the conventional lateral approach. Therefore, we have developed a new approach to the stenotic aorta through a median sternotomy, involving division of the superior vena cava and left caudal displacement of the heart. This approach facilitates extensive dissection and mobilization of the descending aorta in the posterior mediastinum behind the heart and also facilitates direct anastomosis of the aortic arch and the descending aorta after resection of the stenosis. This approach is useful for anatomic repair of postoperative recurrent coarctation of the aorta and other posterior mediastinal procedures.






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