posted on 2021-04-08, 21:45authored byJoseph William. Turek, Neel K. Prabhu, Andrew J. Lodge, James M. Meza
Repair
of aortic coarctation in infants and small children is associated with high
rates of reintervention due to recurrent coarctation and other aortic
pathologies [1]. Use of a curved, geometrically optimized patch during
extensive aortic reconstruction may decrease the risk of re-coarctation by
minimizing kinking and anastomotic torsion. This video captures the conduct of
a successful aortic coarctation repair with a curved patch in a previously
healthy 16 month old male found to have extensive aortic coarctation as well as
long segment narrowing of the aortic isthmus. Post-bypass TEE showed no
evidence of arch obstruction. The patient had a short post-operative hospital
stay and was discharged to home on post-operative day 5. In conclusion, use of
a curved pericardial patch is feasible for aortic reconstruction in infants and
small children. Curved patch geometry may have advantages, such as avoidance of
kinks and folds, when extensive arch augmentation is necessary but further
investigation into long-term outcomes is warranted.