AORTIC OBSTRUCTIONS IN INFANTS AND CHILDREN - SURGERY FOR INTERRUPTED AORTIC-ARCH

Interruption of the aortic arch, a severe form of congenital obstruction of the aorta, is highly lethal if not treated. Over the past four decades, many advances in surgical technique have resulted in markedly improved survival rates for this defect. The preoperative clinical condition of most patients can be improved by intensive medical management with mechanical ventilation, inotropic support, and prostaglandin infusion. In recent years, there has been an increasing interest in and success with complete primary repair in infancy as the technique of choice. Various forms of palliative operative techniques have fair to poor results. A two-stage approach, however, with initial arch repair accompanied by pulmonary artery banding, and a subsequent repair of the intracardiac lesion, can be performed in special circumstances. Recurrent stenosis at the aortic suture line can be treated by either reoperation or balloon angioplasty.