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^a King Faisal Heart Institute (MBC 16), King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia
^b The Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, Ontario, M5G 1X8 Canada

(Email: balsoufi@hotmail.com; christopher.caldarone@sickkids.ca).

The first 20% of the full text of this article appears below.

To the Editor:

We thank Drs Goksel and Tireli [1] for their input. It was interesting to learn about their off-pump technique in repairing coarctation of the aorta (COA) through a sternotomy [2]. In light of our findings [3] and their experience, the following strategies seem appropriate in a neonate with COA and a ventricular septal defect (VSD) that is unlikely to close spontaneously:

1 If the proximal arch is of adequate size with hypoplasia limited to the isthmus area and the distal arch, all of the following options are acceptable: two-stage, two-incision . . . [Full Text of this Article]