Zarrabi Khalil, Ghaffarpasand Fariborz, Zamiri Nima, Ostovan Mohammad Ali
Department of Cardiothoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
J Card Surg. 2012 May;27(3):381-3. doi: 10.1111/j.1540-8191.2012.01446.x. Epub 2012 Apr 12.
To introduce a surgical technique to maintain left upper limb blood flow after subclavian flap aortoplasty (SFA).
Five patients (9 to 23 months of age) with a diagnosis of long-segment aortic coarctation underwent conventional SFA. A Gore-tex graft was interposed between the stump and the proximal descending aorta to maintain perfusion of subclavian artery.
All patients had a patent Gore-tex graft and normal blood flow of the subclavian artery and left upper limb. One patient expired and four others were discharged with a mean follow-up of 48 months. On follow-up all patients had normal development of the left upper limb and no signs of limb ischemia. Echo findings revealed normal arch flow with normal flow in the Gore-tex graft and left upper extremity.
Interposing a Gore-tex graft between the subclavian artery stump and proximal descending aorta concomitant with SFA can be safely performed in infants with long-segment aortic coarctation, with preservation of left upper extremity circulation.
