The Annals of Thoracic Surgery, Vol 37, 25-32, Copyright © 1984 by The Society of Thoracic Surgeons
Interruption of the aortic arch: experience in 17 infants
BN Fowler, SK Lucas, JD Razook, WM Thompson Jr, GR Williams and RC Elkins
Between April, 1965, and August, 1982, 17 children ranging in age from 2
days to 4 years were identified as having interruption of the aortic arch
and operated on at our institution. There were eight type A interruptions,
eight type B interruptions, and one type C interruption. Associated
intracardiac anomalies were present in all but 3 patients. These 3
children, who all had type A interruption, underwent repair by mobilization
of the aorta and end-to-end reconstruction. The other 14 children had
initial palliative operations. The 2 patients in Group 1 had type A
interruption with associated ventricular septal defect (VSD), and underwent
subclavian artery-aorta anastomosis. In Group 2, the palliative procedure
consisted of placement of a Dacron tube graft in 1 patient with type A
interruption and associated VSD, and placement of a polytetrafluoroethylene
(PTFE) graft, division of the patent ductus arteriosus, and banding of the
pulmonary arteries in 11 patients- -2 with type A, 8 with type B, and 1
with type C interruption. Ten children (71%) survived initial palliation, 1
of the 2 in Group 1 and 9 of the 12 in Group 2. In Group 2, 5 children had
interruption of the aortic arch (4, type B; 1, type C) with associated VSD;
among the 4 who survived palliation, 3 subsequently have had successful
closure of the VSD and 1 is awaiting closure. Among the patients who had
palliative procedures, there are 6 long-term survivors (43%). In the total
series, there are 9 long-term survivors (53%).(ABSTRACT TRUNCATED AT 250
WORDS)
