Arcus Aorta Reconstructions in Neonates and Early Infants

Abstract

Introduction: Various instances of aortic arch hypoplasia (AAH) with a wide spectrum of severity have been observed in the neonatal patients. The purpose of this paper is to discuss the aortic arch reconstruction in the coarctation of the aorta and AAH while focusing on the surgical decisions and patient management for the neonatal and infant patients. Patients and Methods:We performed a retrospective review of 15 patients who underwent aortic arch reconstruction. Importantly, we investigated postoperative outcomes with associated complex congenital heart diseases. Results:The median age and mean weight of the patients were 74 days (range: 4-306 days) and 4192 ± 1253 gram, respectively. The surgical correction of aortic arch congenital abnormalities was performed under selective antegrade cerebral perfusion in all the 15 patients. All the reconstructions were performed with pericardial patch, and the coarcted segment of the aorta was completely resected in seven of the patients. One-stage repair was performed in the seven of the patients. The mean follow-up time was 13.7 ± 9.3 months. In one patient, transcatheter balloon angioplasty was performed for re-coarctation six months after operation. There was one early and one late mortality. Conclusion:Aortic arch reconstruction can be performed with a low mortality and morbidity in the newborn and infants.