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  • Title: Modified repair of interrupted aortic arch utilizing retroesophageal right subclavian artery based on a neonatal hybrid approach in hypoplastic left heart complex.
    Author: Valeske K, Mueller M, Hijjeh N, Boening A, Schranz D, Akintuerk H.
    Journal: Thorac Cardiovasc Surg; 2012 Apr; 60(3):221-5. PubMed ID: 22222682.
    Abstract:
    OBJECTIVE: Interrupted aortic arch (IAA) combined with an aberrant right subclavian artery (ARSA) is frequently associated with a hypoplastic ascending aorta. Neonatal surgical therapy carries a high risk particularly for aortic arch obstructions during the further follow-up. METHODS: We performed a modified reconstruction of the aortic arch utilizing the ARSA as a natural substitute in a staged surgical approach. In a novel approach, the distal part of the ARSA is reimplanted into the brachiocephalic trunk. RESULTS: In three patients, a novel arch reconstruction was successfully performed during complete biventricular repair. In a follow-up of 60 to 87 months, the reconstructed aortic arch has grown without any signs of obstruction in all three patients. CONCLUSION: Utilizing the ARSA for surgical aortic arch repair is a satisfactory solution, when postnatal borderline left heart obstruction associated with IAA and ARSA is postponed by an initial hybrid approach.
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