Combined Full Median Sternotomy with Left Thoracotomy Approach for Recoarctation of the Aorta Associated with Aortic Regurgitation
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- Matsuo Satoshi
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
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- Itagaki Kota
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
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- Otani Masayuki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
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- Suzuki Yusuke
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
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- Katahira Shintaro
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
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- Onoki Takehiko
- Department of Pediatrics, Tohoku University Graduate School of Medicine
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- Ota Chiharu
- Department of Pediatrics, Tohoku University Graduate School of Medicine
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- Iwasawa Shinya
- Department of Pediatrics, Tohoku University Graduate School of Medicine
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- Saiki Yoshikatsu
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
Bibliographic Information
- Other Title
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- 大動脈縮窄術後再狭窄および大動脈弁閉鎖不全症に対して側開胸を併施した正中アプローチによる再手術の1例
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Abstract
<p>A 12 years-old boy was identified with coarctation of the aorta and ventricular septal defect at birth. He received extended aortic arch anastomosis for the coarctation of the aorta at the age of 1 month. He required a treatment with balloon angioplasty postoperatively for recurrent coarctation twice. On the other hand, recurrent coarctation subsequently occurred and severe aortic valve regurgitation also emerged. The recurrent coarctation developed to a minimum diameter of 5 mm and a pressure gradient of 50 mmHg across a total length of 4 cm of stenotic lesion by close examination at the age of 11 years. Moreover, severe aortic valve regurgitation was found. He had descending thoracic aortic replacement, aortic valve replacement, and ventricular septal defect closure through combined median sternotomy and left antero-lateral thoracotomy, taking considering factors such as anticipated severe adhesion around the aorta, secured establishment of selective cerebral perfusion and facilitated intracardiac repair. The postoperatively, the pressure gradient between the upper and lower limbs was diminished. Although catheter intervention and extraanatomical bypass have been variably reported for patients with recurrent coarctation, these procedures leave specific concerns in the late term. On the other hand, combined median sternotomy and left antero-lateral thoracotomy could facilitate the intracardiac repair and allow us to complete a highly curative procedure conforming anatomical repair of coarctation at the expense of seemingly excessive invasiveness.</p>
Journal
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- Pediatric Cardiology and Cardiac Surgery
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Pediatric Cardiology and Cardiac Surgery 39 (1), 31-36, 2023-02-01
Japanese Society of Pediatric Cardiology and Cardiac Surgery
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Keywords
Details 詳細情報について
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- CRID
- 1390579156089755648
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- ISSN
- 21872988
- 09111794
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
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- Abstract License Flag
- Disallowed