Anterior arch translocation for coarctation of circumflex aorta using median sternotomy without cardiopulmonary bypass

Abstract

Comparison of the hemodynamic performance of percutaneous and surgical bioprostheses for the treatment of severe aortic stenosis.

Circumflex aorta: An uncharted territory

“…In the absence of intracardiac defect, the "ductal theory" possibly explains the co-existence of coarctation. 28 Circumflex aortic arches with coarctation are repaired either through a thoracotomy or sternotomy. The aortic continuity can be established either anastomosing native tissues or with an extra anatomic graft connecting the ascending and the descending aorta.…”

“…The surgery was done via median sternotomy without the use of CPB. 28 Bleakney et al reported a four-year-old boy with right circumflex aortic arch with associated arch hypoplasia, coarctation, and an aberrant isolated LSCA treated with resection of the circumflex arch, aortic arch advancement with end-to-side anastomosis and anastomosis of LSCA to the left common carotid artery. 13 Benefits of using native tissue include the ability of tissues to grow and accommodate changes in the morphology of a growing child and potentially, a reduced risk of infection.…”

Circumflex aorta with double aortic arch in an infant

“…In addition, since she had a circumflex aortic arch, we made plans to perform an aortic uncrossing procedure if the division of the vascular ring did not adequately relieve the obstruction. The surgery could also be done via a median sternotomy without cardiopulmonary bypass using the side‐biting clamp on the ascending aorta . Some modifications have been made to the uncrossing procedure to address the unusual anatomy in heterotaxy single‐ventricle hearts by incorporating the arch into the Damus‐Kaye‐Stansel anastomosis .…”

Concurrent double aortic arch and circumflex aorta repair in a symptomatic child: a case report

“…Aortic uncrossing is a complex operation generally utilizing cardiopulmonary bypass ± deep hypothermic circulatory arrest that relocates the aortic arch anterior to the trachea and esophagus. Modifications may allow for the avoidance of cardiopulmonary bypass, however, aortic uncrossing remains a more complex procedure with a higher risk of major complication such as bilateral recurrent laryngeal nerve injury, compared to a thoracotomy approach for division of the lesser arch and ligamentum arteriosum [ 5 , 6 ]. It is unclear whether primary presenting symptomatology (e.g.…”