Surgical Repair for Coarctation of the Aorta

Coarctation of the aorta is a congenital narrowing of the upper descending aorta adjacent to the site of attachment of ductus arteriosus. In neonates and young infants, surgical repair is the treatment of choice. The most common contemporary technique used is resection and end-to-end anastomosis, and if anatomically warranted, an extended end-to-end anastomosis. This video illustrates the steps of coarctation repair by extended end-to-end anastomosis through a left posterolateral thoracotomy. Important steps are: thoracotomy, opening of mediastinal pleura, mobilization of the ductus, descending aorta and aortic arch, ligation of the ductus, and resection of the coarctation segment and extension of the incision on the base of the arch, followed by anastomosis with continuous sutures. The mediastinal pleura was approximated and the chest was closed over a pleural drain.

Reference

Sen S, Garg S, Rao SG, Kulkarni S. Native aortic coarctation in neonates and infants: Immediate and midterm outcomes with balloon angioplasty and surgery. Ann Pediatr Card. 2018;11:261-166.