Isthmus Flap Aortoplasty for Repair of Long-segment Coarctation of the Aorta

Abstract

Although resection with end-to-end anastomosis is currently the standard approach in the patients with coarctation of the aorta, repair for a long and narrow isthmus has been a surgical challenge. Herein, we describe a novel surgical technique including aortic isthmus reconstruction that allows for direct anastomosis without the use of foreign materials or tension-relieving procedures such as subclavian flap aortoplasty. Although resection with end-to-end anastomosis is currently the standard approach in the patients with coarctation of the aorta, repair for a long and narrow isthmus has been a surgical challenge. Herein, we describe a novel surgical technique including aortic isthmus reconstruction that allows for direct anastomosis without the use of foreign materials or tension-relieving procedures such as subclavian flap aortoplasty. Commentary: Isthmus Flapping – Another Tool in the Box for CoarctationOperative Techniques in Thoracic and Cardiovascular SurgeryVol. 26Issue 3PreviewMiyahara et al. provide a clear description of a novel all native tissue solution to the problem of coarctation associated with long segment isthmus hypoplasia that preserves the left subclavian artery.1 I won't comment further on the issue of on-pump via sternotomy versus an off-pump left chest approach with a suitable ductus arteriosus. The flap technique is a useful to addition to the many tools and tricks we already employ for various coarctation morphologies and demands no complicated technical maneuvers. Full-Text PDF