Objective
To evaluate cardiovascular outcomes in patients with aortic arch repair and their
possible correlation with arch geometry.
Methods
Ten patients who underwent end-to-side repair for aortic arch interruption (IAA),
older than 10 years were compared to a cohort of 10 post coarctation (CoA) repair
patients matched for age, sex and age at repair. Mean age at operation was 9.7 ± 6.5 days. Patients underwent a resting and 24 h blood pressure measurements, exercise study, MRI, transthoracic echocardiography
and vascular studies.
Results
Seven patients developed hypertension, two from IAA group and five from CoA group.
Nine patients (45%) had gothic arch geometry, three from IAA group and six from CoA
group. Despite differences in arch geometry, both groups had normal LV mass, LV function
and vascular function.
Conclusion
No differences in functional or morphologic outcomes could be demonstrated between
the end-to-side repair of the arch by sternotomy and the conventional coarctation
repair by thoracotomy. A favourable arch geometry can be achieved after the end-to-side
repair of the aortic arch. In the present study, we could not correlate adverse arch
geometry with any adverse cardio-vascular outcomes. After neonatal arch repair, the
contributive role of aortic arch geometry to late hypertension remains uncertain.
Keywords
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Article info
Publication history
Published online: September 23, 2013
Accepted:
August 9,
2013
Received in revised form:
July 13,
2013
Received:
August 1,
2012
Identification
Copyright
© 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
