Hybrid Surgical Repair for Recurrent Coarctation of the Transvers Arch:
Case Report
Abstract
The incidence of postoperative recurrent coarctation of the aorta ranges
from 5% to 50%, and largely depends on the age at initial repair. Due
to the increased fibrosity and rigidity of the aorta in older age, stent
placement is preferred instead of balloon angioplasty, resulting in an
almost complete relief of the gradient in >95% of the
patients. In patients with transverse arch hypoplasia, transcatheter
intervention with further surgical intervention may be needed, and the
use of stenting was shown to be effective in the treatment of patients
with hypoplastic isthmus, arch or tubular coarctation. In this case of a
late re-coarctation, we preferred to apply a hybrid technique for
treatment. The first step of the treatment was debranching of the
brachiocephalic and left common carotid arteries with upper mini median
sternotomy. On the following day, the patient underwent a successful
stent placement to the transvers arch.