Interruption of the aortic arch in an infant with left subclavian steal syndrome. Case report.

An unusual case of interruption of the aortic arch with flow to the descending aorta through the left vertebral and left subclavian arteries is described. The ductus arteriosus was functionally closed. The aortic arch was reconstructed with a PTFE graft, but the patient died because of lung problems, related to a high left-to-right shunt through a ventricular septal defect. A new surgical approach is postulated in view of the unusual hemodynamic features. Surgical control of pulmonary congestion could be the initial step, followed by aortic arch reconstruction later when insertion of a non-restrictive aortic prosthesis is possible.