Swing-back and trap-door technique repair for interrupted aortic arch with right-sided descending aorta

Shiraishi, Shuichi; Sugimoto, Ai; Tsuchida, Masanori

doi:10.1093/icvts/ivz175

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…13,14 Additionally, a preoperative right-sided descending aorta might also be a risk factor for airway obstruction after aortic arch reconstruction. 15 McKenzie et al showed that vascular compression of the left main bronchus after AAA could be associated with having a midline descending aorta, which could occur in patients with vascular rings with or without previous division. 16 In this study, the risk factors for postoperative LBC were a close preoperative location of the descending aorta in relation to the SSA and a high position of the aortic arch in relation to the left tracheal bronchus (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

Left bronchial compression after aortic arch reconstruction for coarctation of the aorta

Ishimaru

Iwai

2023

Asian Cardiovasc Thorac Ann

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Background This study aimed to investigate the preoperative positional relationships between the blood vessels and the left bronchus during the development of left bronchial compression (LBC) after aortic arch reconstruction for coarctation of the aorta (CoA). Methods We retrospectively reviewed data from 29 patients with CoA who underwent aortic arch reconstruction via median sternotomy between 2009 and 2019. The patients were divided into those who underwent aortic arch advancement (AAA) with (C group, six patients) or without (N group, 10 patients) postoperative LBC and those who underwent extended end-to-end anastomosis (E group, 13 patients). We determined the sterno-spinal axis (SSA) of the patients and evaluated the preoperative and postoperative positions of the vessels on the axial and three-dimensional multidetector row computed tomography (CT) angiographic images. Results The distance between the ascending and descending aortas was significantly smaller in both C and N groups postoperatively than preoperatively. The distance between the descending aorta and SSA in the C group was markedly smaller compared with that in the other groups preoperatively and was increased postoperatively. Preoperatively, the distance from the left bronchus to the aortic arch in the C group was significantly larger than that in the other groups and was decreased postoperatively. The postoperative arch angle in the C group was significantly smaller than that in the other groups. Conclusion A preoperative midline position of the descending aorta and highly displaced aortic arch in relation to the left bronchus on preoperative CT images could cause the postoperative LBC after AAA.

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