Reconstructive surgery of aortic arch interruption in adults

Abstract

AIM: To evaluate surgical results in adults with aortic arch interruption. MATERIAL AND METHODS: Seven patients with aortic arch interruption were operated. Two of them (28.6%) underwent aortic arch repair using allograft, 4 (57.21%) - distal arch and proximal descending aortic replacement, 1 (14.3%) - supra-coronary ascending aortic, aortic arch and proximal descending aortic replacement. All operations were performed under moderate hypothermia (25 °С), circulatory arrest with unilateral cerabral perfusion 8-10 ml/kg/min via innominate artery and pressure 69.6±14.7 mm Hg in arterial. RESULTS: Cardiopulmonary bypass (CPB) time was 242±36.1 min, aortic cross-clamping - 110.7±40.4 min, circulatory arrest - 58.6±17.9 min. There were no cases of renal insufficiency, vascular lesion of brain and spinal cord, cardiac events. Resternotomy for bleeding was performed in 1 (14.3%) case. Sufficient descending aortic lumen was achieved in 100% according to CT postoperatively. Peak descending aortic pressure gradient after repair with allograft was 29±1.4 mm Hg, after aortic replaement - 10±4.2 mm Hg. Postoperative and in-hospital 30-day mortality was absent. CONCLUSION: Reconstructive surgery for aortic arch interruption in adults is effective approach with good clinical and hemodynamic results.