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  • Title: [Extended aortic arch anastomosis for aortic coarctation in neonate and early infancy--experience in 5 patients].
    Author: Matsuda H, Kasai Y, Shimazaki Y, Kawamoto T, Sawa Y, Inoue T, Fukushima N, Tokuann Y, Ogawa M, Kawashima Y.
    Journal: Nihon Kyobu Geka Gakkai Zasshi; 1989 Sep; 37(9):1917-22. PubMed ID: 2600465.
    Abstract:
    The aortic coarctation (CoA) was repaired with extended aortic arch (AA) anastomosis in 5 consecutive patients, 2 in neonate and 3 in infancy, ranging in age from 3 to 106 days. The associated lesions were ventricular septal defect in 2, atrial septal defect in 2 and complete atrioventricular canal in 1. Patent ductus was found in 4 and prostaglandin E1 was required in 2 with response in 1 patient. The AA was hypoplastic in 2 patients with arch to descending aorta diameter ratio below 0.5. The CoA repair was performed as the first procedure in all. The primary anastomosis was possible in all between AA and the descending aorta without undue tension after removal of the all ductus tissue and extensive mobilization of the aorta. Aortic clamp time was 28 minutes in average. The intraoperative pressure gradient after repair across AA was 0 to 10 mmHg (average 4.6 mmHg). All except 1 with preceding hepatic dysfunction tolerated the procedure without complication or operative death. Postoperative evaluation at 1 to 11 months showed no significant pressure gradient between upper and lower extremities. This method appears to be useful for CoA in early infancy particularly when AA is hypoplastic.
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