Neonatal repair of right interrupted aortic arch with cerebro-myocardial perfusion technique

Interactive Cardiovascular and Thoracic Surgery
Koh TakeuchiKeiji Tsuchiya

Abstract

Right interrupted aortic arch and descending aorta is exceedingly rare and most likely cause respiratory presentation, since patent ductus arteriosus (PDA) courses over the right mainstem bronchus. We report a case of successful neonatal biventricular repair of a right interrupted aortic arch (type B), with an aberrant right subclavian artery ventricular septal defect (VSD) in a 2.7 kg term neonate with DiGeorge syndrome. Patient presented in severe respiratory distress and acidosis at one day old. Two-dimensional (2D) echocardiography revealed aortic arch interruption beyond the common carotid arteries with large perimembranous outlet VSD. Aortic annulus diameter was 4.8 mm and there was no left ventricle (LV) outflow tract obstruction. Three-dimensional (3D) CT-scan confirmed these findings and identified a right-sided ductal arch that continued over the right mainstem bronchus into a right-sided descending aorta and aberrant right subclavian artery. Brachiocephalic perfusion and ductal perfusion was employed for cooling during cardiopulmonary bypass. Under deep hypothermia (27 °C rectal temperature), selective cerebro-myocardial perfusion was used for successful aortic arch repair without sacrificing the aberrant right subcl...Continue Reading

References

Apr 22, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·John W BrownMark W Turrentine
Nov 28, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hong-Gook LimChang-Ha Lee
Feb 3, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Michael W A ChuChristo I Tchervenkov
Jun 6, 2009·Interactive Cardiovascular and Thoracic Surgery·Stephen WestabyFidelma Flynn
Feb 19, 2010·Pediatric Cardiology·Ryo Aeba, Ryohei Yozu

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Citations

Jul 4, 2012·Interactive Cardiovascular and Thoracic Surgery·Santosh C UppuMichiaki Imamura
Jan 25, 2014·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·M BoukhrisR Boussaada

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