Outcomes of interrupted aortic arch repair using the carotid artery turndown procedure

Steven H. Todman, Osama Eltayeb, Mark Ruzmetov, Mark Rodefeld, Mark Turrentine, John Brown, John P. Breinholt

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: Interrupted aortic arch is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease. Multiple surgical modalities exist to address this defect. We evaluate the long-term outcome of interrupted aortic arch with the left carotid artery turndown technique from a single institution. Methods: Patients with interrupted aortic arch who underwent the carotid turndown procedure were identified between September 1982 and March 2010. Medical and surgical records were reviewed. Mortality data were obtained from state death records. Results: Forty-seven patients met inclusion criteria. Median follow-up was 6.2 years (5 days to 23.2 years). Twenty-one patients (45%) had genetic syndromes. There were 4 operative deaths (8.5%) and 9 late deaths (19%). One-year and 5-year survivals were 80.2% and 72.6%, respectively. Seventeen patients (36.2%) required reoperation or other interventions on the aortic arch. Conclusions: Left carotid artery turndown offers a favorable surgical outcome. It compares with end-to-end repair, while providing a tension-free anastomosis and avoiding neonatal circulatory arrest and cardiopulmonary bypass. Disadvantages include a 2-stage repair and a significant reintervention rate, particularly when compared with the aortic arch advancement technique. Nevertheless, the reduced exposure to circulatory arrest and bypass and avoidance of left bronchial obstruction are important considerations that may offset these limitations.

Original languageEnglish
Pages (from-to)176-182
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume145
Issue number1
DOIs
StatePublished - Jan 2013

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Thoracic Aorta
Carotid Arteries
Death Certificates
Cardiopulmonary Bypass
Reoperation
Medical Records
Heart Diseases
Survival
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Outcomes of interrupted aortic arch repair using the carotid artery turndown procedure. / Todman, Steven H.; Eltayeb, Osama; Ruzmetov, Mark; Rodefeld, Mark; Turrentine, Mark; Brown, John; Breinholt, John P.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 1, 01.2013, p. 176-182.

Research output: Contribution to journalArticle

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AU - Brown, John

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