A NEW SURGICAL TECHNIQUE FOR REPAIR OF AORTIC COARCTATION

Abstract

From June, 1987, to February, 1989, 7 patients underwent a new technique of coarctation repair. This technique consists of a complete mobilization of the left subclavian artery (LSA) so that it can be pulled down as much as possible. After all the proper clamping, the anterior wall of the aorta is incised longitudinally, beginning on the anterior wall of the LSA and extending distally to the descending aorta 2 cm past the coarctation. The coarctation membrane is excised carefully. The LSA is pulled down so that the proximal end of the incision can come to the distal end. Then, this longitudinal incision is sutured transversely with 5/0 polydiaxonone and continuous technique, widening the coarctation site and also preserving the blood flow to the left upper limb. If extreme tension occurs, the LSA is transected. After the aortoplasty is completed, a polytetrafluoroethylene (PTFE) graft in size of 6 or 8 mm is interposed between the proximal and the distal parts of the LSA, providing continuity.