{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T12:53:01Z","timestamp":1769345581453,"version":"3.49.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To analyse the technique of neonatal aortic arch enlargement without cardiopulmonary bypass through a left posterior thoracotomy, as an adjunct to extended resection for Coarctation and severe arch hypoplasia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Ten neonates with coarctation, severe arch hypoplasia and a persistent ductus arteriosus (PDA) were subjected to arch repair through a left posterior thoracotomy. Nine of these patients had associated significant intracardiac anomalies; three of them received pulmonary artery (PA) banding. After exclusion from circulation, the roof of the intervening arch between left carotid and left subclavian was enlarged using a patch. After adequate reperfusion, a classic resection and extended end-to-end anastomosis was performed. Median age and weight were 5.5 (1\u201310) days and 3.3 (2.2\u20134.1)\u00a0kg respectively. The median preoperative arch diameter was 1.07 (0.75\u20131.32)\u00a0mm\/kg body weight.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>All patients could be successfully operated with this approach. The non-ischaemic and ischaemic aortic clamp times were 40 (15\u201368) and 23 (18\u201332)\u00a0min, respectively. The median postoperative arch diameter achieved was 1.43 (1.06\u20131.46)\u00a0mm\/kg body weight. None of the patients had significant gradient early postoperatively. Two patients with recurrent stenosis were successfully treated with balloon dilatation (1) or surgery with cardiopulmonary bypass (CPB) (1). One patient has a corrected gradient of 16\u00a0mmHg in the proximal arch which is being observed. The remaining patients are free from stenosis at a median follow-up of 30.1 (13.2\u201357.8) months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Use of PDA for lower body perfusion allows complex reconstruction of the arch without incurring lower body ischaemia. The extended resection could then be performed without excessive stretch. This modification saves these patients from undergoing a complex arch reconstruction with CPB in the early neonatal period.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezr110","type":"journal-article","created":{"date-parts":[[2011,12,22]],"date-time":"2011-12-22T01:53:08Z","timestamp":1324518788000},"page":"906-912","source":"Crossref","is-referenced-by-count":9,"title":["Aortic arch enlargement and coarctation repair through a left thoracotomy: significance of ductal perfusion"],"prefix":"10.1093","volume":"41","author":[{"given":"Hitendu","family":"Dave","sequence":"first","affiliation":[{"name":"University Children\u2019s Hospital Zurich a Division of Congenital Cardiovascular Surgery , , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Rosser","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich a Division of Congenital Cardiovascular Surgery , , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Reineke","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich a Division of Congenital Cardiovascular Surgery , , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvie","family":"Nguyen-Minh","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich a Division of Congenital Cardiovascular Surgery , , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Knirsch","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich b Department of Paediatric Cardiology , , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9","family":"Pr\u00eatre","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich a Division of Congenital Cardiovascular Surgery , , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2011,12,21]]},"reference":[{"key":"2024102217592944800_EZR110C1","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1016\/S0003-4975(01)02444-4","article-title":"Reverse subclavian flap repair of hypoplastic transverse aorta in infancy","volume":"71","author":"Kanter","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"2024102217592944800_EZR110C2","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.athoracsur.2005.06.056","article-title":"Muscle-sparing extrapleural approach for the repair of aortic coarctation","volume":"81","author":"Dave","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"2024102217592944800_EZR110C3","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1016\/j.athoracsur.2005.04.041","article-title":"Carotid-subclavian artery index: new echocardiographic index to detect coarctation in neonates and infants","volume":"80","author":"Dodge-Khatami","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"2024102217592944800_EZR110C4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.athoracsur.2008.08.072","article-title":"Clarence Crafoord: a giant in cardiothoracic surgery, the first to repair aortic coarctation","volume":"87","author":"Kvitting","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"2024102217592944800_EZR110C5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0022-5223(94)70456-2","article-title":"Surgical treatment of aortic coarctation in infants younger than three months: 1985 to 1990. 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