Coarctation repair

Modification of end-to-end anastomosis with subclavian flap angioplasty

Hagop Hovaguimian, V. Senthilnathan, John P. Iguidbashian, David M. McIrvin, Albert Starr

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. Subclavian angioplasty and resection and end-to-end anastomosis for coarctation repair carry a substantial risk of recurrence of coarctation. The combined technique using both these methods has shown good results but requires a longer period of continuous cross-clamping of the aorta. Methods. A modified technique using intermittent cross-clamping with a period of reperfusion between cross-clamping periods was used. After the end- to-end anastomosis the clamps are released for 10 minutes and reapplied to do the subclavian angioplasty. Between 1991 and 1996 this was done in 26 infants (mean age, 5 weeks; range, 1 day to 6 months; median, 3 weeks). Mean weight was 3.85 kg (range, 1.5 to 8.4 kg). Mean length of follow-up was 23 months. Twenty-two patients (85%) had associated anomalies, excluding patent ductus arteriosus, and 5 patients (19%) had another procedure performed at the same time. Results. There was no mortality. The mean echocardiographic gradient was 4 mm Hg in the immediate postoperative period and 2.9 mm Hg during follow-up. Residual or recurrent coarctation as detected by significant echocardiography or blood pressure gradient did not develop in any infant. Conclusions. This modified technique of anastomosis is an effective way of relieving coarctation with excellent intermediate-term results.

Original languageEnglish (US)
Pages (from-to)1751-1754
Number of pages4
JournalAnnals of Thoracic Surgery
Volume65
Issue number6
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Angioplasty
Constriction
Patent Ductus Arteriosus
Postoperative Period
Reperfusion
Echocardiography
Aorta
Blood Pressure
Weights and Measures
Recurrence
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Hovaguimian, H., Senthilnathan, V., Iguidbashian, J. P., McIrvin, D. M., & Starr, A. (1998). Coarctation repair: Modification of end-to-end anastomosis with subclavian flap angioplasty. Annals of Thoracic Surgery, 65(6), 1751-1754. https://doi.org/10.1016/S0003-4975(98)00271-9

Coarctation repair : Modification of end-to-end anastomosis with subclavian flap angioplasty. / Hovaguimian, Hagop; Senthilnathan, V.; Iguidbashian, John P.; McIrvin, David M.; Starr, Albert.

In: Annals of Thoracic Surgery, Vol. 65, No. 6, 1998, p. 1751-1754.

Research output: Contribution to journalArticle

Hovaguimian, H, Senthilnathan, V, Iguidbashian, JP, McIrvin, DM & Starr, A 1998, 'Coarctation repair: Modification of end-to-end anastomosis with subclavian flap angioplasty', Annals of Thoracic Surgery, vol. 65, no. 6, pp. 1751-1754. https://doi.org/10.1016/S0003-4975(98)00271-9
Hovaguimian, Hagop ; Senthilnathan, V. ; Iguidbashian, John P. ; McIrvin, David M. ; Starr, Albert. / Coarctation repair : Modification of end-to-end anastomosis with subclavian flap angioplasty. In: Annals of Thoracic Surgery. 1998 ; Vol. 65, No. 6. pp. 1751-1754.
@article{2e96284452b84665a7460d402550bc78,
title = "Coarctation repair: Modification of end-to-end anastomosis with subclavian flap angioplasty",
abstract = "Background. Subclavian angioplasty and resection and end-to-end anastomosis for coarctation repair carry a substantial risk of recurrence of coarctation. The combined technique using both these methods has shown good results but requires a longer period of continuous cross-clamping of the aorta. Methods. A modified technique using intermittent cross-clamping with a period of reperfusion between cross-clamping periods was used. After the end- to-end anastomosis the clamps are released for 10 minutes and reapplied to do the subclavian angioplasty. Between 1991 and 1996 this was done in 26 infants (mean age, 5 weeks; range, 1 day to 6 months; median, 3 weeks). Mean weight was 3.85 kg (range, 1.5 to 8.4 kg). Mean length of follow-up was 23 months. Twenty-two patients (85{\%}) had associated anomalies, excluding patent ductus arteriosus, and 5 patients (19{\%}) had another procedure performed at the same time. Results. There was no mortality. The mean echocardiographic gradient was 4 mm Hg in the immediate postoperative period and 2.9 mm Hg during follow-up. Residual or recurrent coarctation as detected by significant echocardiography or blood pressure gradient did not develop in any infant. Conclusions. This modified technique of anastomosis is an effective way of relieving coarctation with excellent intermediate-term results.",
author = "Hagop Hovaguimian and V. Senthilnathan and Iguidbashian, {John P.} and McIrvin, {David M.} and Albert Starr",
year = "1998",
doi = "10.1016/S0003-4975(98)00271-9",
language = "English (US)",
volume = "65",
pages = "1751--1754",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Coarctation repair

T2 - Modification of end-to-end anastomosis with subclavian flap angioplasty

AU - Hovaguimian, Hagop

AU - Senthilnathan, V.

AU - Iguidbashian, John P.

AU - McIrvin, David M.

AU - Starr, Albert

PY - 1998

Y1 - 1998

N2 - Background. Subclavian angioplasty and resection and end-to-end anastomosis for coarctation repair carry a substantial risk of recurrence of coarctation. The combined technique using both these methods has shown good results but requires a longer period of continuous cross-clamping of the aorta. Methods. A modified technique using intermittent cross-clamping with a period of reperfusion between cross-clamping periods was used. After the end- to-end anastomosis the clamps are released for 10 minutes and reapplied to do the subclavian angioplasty. Between 1991 and 1996 this was done in 26 infants (mean age, 5 weeks; range, 1 day to 6 months; median, 3 weeks). Mean weight was 3.85 kg (range, 1.5 to 8.4 kg). Mean length of follow-up was 23 months. Twenty-two patients (85%) had associated anomalies, excluding patent ductus arteriosus, and 5 patients (19%) had another procedure performed at the same time. Results. There was no mortality. The mean echocardiographic gradient was 4 mm Hg in the immediate postoperative period and 2.9 mm Hg during follow-up. Residual or recurrent coarctation as detected by significant echocardiography or blood pressure gradient did not develop in any infant. Conclusions. This modified technique of anastomosis is an effective way of relieving coarctation with excellent intermediate-term results.

AB - Background. Subclavian angioplasty and resection and end-to-end anastomosis for coarctation repair carry a substantial risk of recurrence of coarctation. The combined technique using both these methods has shown good results but requires a longer period of continuous cross-clamping of the aorta. Methods. A modified technique using intermittent cross-clamping with a period of reperfusion between cross-clamping periods was used. After the end- to-end anastomosis the clamps are released for 10 minutes and reapplied to do the subclavian angioplasty. Between 1991 and 1996 this was done in 26 infants (mean age, 5 weeks; range, 1 day to 6 months; median, 3 weeks). Mean weight was 3.85 kg (range, 1.5 to 8.4 kg). Mean length of follow-up was 23 months. Twenty-two patients (85%) had associated anomalies, excluding patent ductus arteriosus, and 5 patients (19%) had another procedure performed at the same time. Results. There was no mortality. The mean echocardiographic gradient was 4 mm Hg in the immediate postoperative period and 2.9 mm Hg during follow-up. Residual or recurrent coarctation as detected by significant echocardiography or blood pressure gradient did not develop in any infant. Conclusions. This modified technique of anastomosis is an effective way of relieving coarctation with excellent intermediate-term results.

UR - http://www.scopus.com/inward/record.url?scp=0031809423&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031809423&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(98)00271-9

DO - 10.1016/S0003-4975(98)00271-9

M3 - Article

VL - 65

SP - 1751

EP - 1754

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 6

ER -