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Ann Thorac Surg 1976;21:243-246
© 1976 The Society of Thoracic Surgeons


Articles

Interrupted Aortic Arch: Factors Influencing Prognosis

J.R. Allard, M.D., R.L. Williams, M.D., A.R.C. Dobell, M.D.*

From the Division of Cardiovascular and Thoracic Surgery, McGill University and The Montreal Children's Hospital, Montreal, Que, Canada

Accepted for publication August 19, 1975.

* Address reprint requests to Dr. Dobell, Montreal Children's Hospital, 2300 Tupper St, Montreal, Que, Canada H3HIP3


    Abstract
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 Abstract
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From January, 1969, to June, 1974, 11 infants with interrupted aortic arch were operated upon. Eight of them died in the perioperative period. Their cases were reviewed in an attempt to find factors influencing the prognosis. Age, weight, preoperative hemodynamics, angiographic findings, and the type of arch anomaly did not influence the outcome. The operation, whether palliative or involving intracardiac repair, did not affect the prognosis.

The only factor related to the outcome was the size of the conduit: in all infants who died, the vessel used to bridge the gap (carotid or subclavian artery) was of narrow diameter. In the 3 patients who survived it was of much larger bore.

We conclude that in the repair of interrupted aortic arch, an adequate conduit is essential for success.


    Footnotes
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We thank Dr. D. A. Murphy for permission to include patients operated upon by him.


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  1. Barratt-Boyes BG, Nichols TT, Brandt PWT, et al. Aortic arch interruption associated with patent ductus arteriosus, ventricular septal defect, and total anomalous pulmonary venous connection J Thorac Cardiovasc Surg 1972;63:367.[Medline]
  2. Blake HA, Manion WC, Spencer FC. Atresia or absence of the aortic isthmus J Thorac Cardiovasc Surg 1962;43:607.[Medline]
  3. Celoria GC, Patton RB. Congenital absence of the aortic arch Am Heart J 1959;58:407.[Medline]
  4. Marcial MB, Gregori Jr F, Snitconsky R, et al. Anastomosis of the subclavian artery to the descending aorta for the correction of interrupted aortic arch J Thorac Cardiovasc Surg 1973;66:653.[Medline]
  5. Merrill DL, Webster CA, Samson PC. Congenital absence of the aortic isthmus J Thorac Surg 1957;33:311.[Medline]
  6. Murphy DA, Collins G, Dobell ARC. Surgical correction of type A congenital aortic arch interruption Ann Thorac Surg 1971;11:593.[Abstract/Free Full Text]
  7. Murphy DA, Lemire GG, Tessler I, et al. Correction of type B aortic arch interruption with ventricular and atrial septal defects in a three-day-old infant J Thorac Cardiovasc Surg 1973;65:882.[Medline]
  8. Pillsbury RC, Lower RR, Shumway NE. Atresia or absence of the aortic arch Circulation 1964;30:749.[Abstract/Free Full Text]
  9. Reul Jr GJ, Kabbani SS, Sandiford FM, et al. Repair of coarctation of the thoracic aorta by patch graft aortoplasty J Thorac Cardiovasc Surg 1974;68:696.[Medline]
  10. Roberts WC, Morrow AG, Braunwald E. Complete interruption of the aortic arch Circulation 1972;26:39.
  11. Sirak HD, Ressalat M, Hosier DM, et al. A new operation for repairing aortic arch atresia in infancy Circulation 1968;37(Suppl 2):43.
  12. Trusler GA, Izukawa T. Interrupted aortic arch and ventricular septal defect: direct repair through a median sternotomy incision in a 13-day-old infant J Thorac Cardiovasc Surg 1975;69:126.[Abstract]
  13. Van Praagh R, Bernhard WF, Rosenthal A, et al. Interrupted aortic arch: surgical treatment Am J Cardiol 1971;27:200.[Medline]
  14. Villalobos MCR, De Balderrama DP, Lopez JL, et al. Complete interruption of the aorta Am J Cardiol 1961;8:664.[Medline]



This article has been cited by other articles:


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Ann. Thorac. Surg.Home page
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Repair of interrupted aortic arch with an augmented aortic anastomosis
Ann. Thorac. Surg., July 1, 1993; 56(1): 142 - 148.
[Abstract] [PDF]


This Article
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