ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Long-term outcome after repair of interrupted aortic arch in a single centre†.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMortality in patients with interrupted aortic arch (IAA) rates among the highest in congenital heart surgery. Various techniques for aortic arch repair are described; reintervention rates remain substantial. This retrospective single-centre study aimed to evaluate the long-term outcome in a biventricular series with a preferably performed direct anastomosis and one-stage repair.
methodsAt the Children's Heart Center Linz, 58 biventricular patients with IAA were operated between 1999 and 2023. Median age at operation was 10 [7; 15] days and weight was 3.3 [3; 3.7] kg. In the 24 children with ventricular septal defects (VSDs) only, the arch was repaired by a direct anastomosis. Thirty-four had complex concomitant heart defects, and the arch reconstruction was performed by direct anastomosis (20), direct anastomosis + patch (10), reverse subclavian flap + patch (3) and aortic autograft + patch (1).
resultsMedian cardiopulmonary bypass time was 222 [159; 315] min, and aortic cross-clamp time was 94 [75; 143] min. Two patients died during the hospital stay (4%), two patients after discharge (4%), and four (7%) required an arch reintervention during a follow-up period of median 9.3 [6.2; 17.2] years. There was no death or arch reintervention in the VSD group.
conclusionsAll-cause mortality in biventricular patients with IAA was 7%, and the arch reintervention rate was 8%. Direct aortic anastomosis in patients with VSD can only be performed with excellent outcomes, with no deaths or arch reinterventions being observed after a follow-up up to 24 years. CLINICAL REGISTRATION NUMBER: EK Nr 1268/2021, Ethics committee of the Medical Faculty at Johannes Kepler University Linz.
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