![]() Solitary interruption of the arch of the aorta. Risk factors associated with mortality and interventions in 472 neonates with interrupted aortic arch: a Congenital Heart Surgeons Society study. McCrindle BW, Tchervenkov CI, Konstantinov IE, Williams WG, Neirotti RA, Jacobs ML, Blackstone EH. Congenital Heart Surgery Nomenclature and Database Project: patent ductus arteriosus, coarctation of the aorta, interrupted aortic arch. Anatomic features affect mortality and initial LVOT procedures, whereas characteristics of the arch repair affect arch reintervention. Recurrence of arch obstruction has been reported from 10 to 30 %, while recurrence of LVOTO has averaged 20 %. Current early mortality for repair of IAA with VSD ranges from 4 to 10 %. A severe LVOTO may require more aggressive procedures, e.g. Aortic arch reconstruction is accomplished by end-to-side anastomosis with the ascending aorta, more or less associated with patch augmentation of the anastomosis. Staged repair was popular in the past, but primary repair through a median sternotomy (using either deep hypothermic circulatory arrest or moderately hypothermic antegrade selective cerebral perfusion) is currently the preferred approach. DiGeorge syndrome is another frequently associated feature with important clinical implications. Careful preoperative assessment, and particularly the identification of a severe left ventricular outflow tract obstruction (LVOTO, <4 mm), is crucial for a successful outcome. The critical condition of these neonates dictates early referral and surgical treatment. Only type B is, but not exclusively, a true cono-truncal anomaly. Three types of IAA – A, B and C – are classicaly recognized. Interrupted aortic arch (IAA), usually associated with a ventricular septal defect (VSD), is a rapidly fatal congenital heart anomaly with ductus-dependent systemic circulation.
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