Complete Repair of Aortic Coarctation and Ventricular Septal Defect without Cardiopulmonary Bypass

Alexey Voitov, Alexander Omelchenko, Yuriy Gorbatykh, Artem Gorbatykh, Ilya Soynov, Nataliya Nichay, Yuriy Kulaybin, Alexey Zubritskiy, Alexandr Bogachev-Prokophiev, Alexandr Karaskov

«E.Meshalkin National medical research center» of the Ministry of Health of the Russian Federation, Novosibirsk, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – D

Abstract

OBJECTIVES:

Aortic coarctation with ventricular septal defect can be treated without cardiopulmonary bypass using hybrid method (arch repair via left thoracotomy and transventricular VSD closure via minithternotomy). The aim of the study was to assess safety and efficacy these combine technique in newborns and infants in the early and mid-term period.

PATIENTS AND METHODS:

Between August 2013 and September 2017, 21 consecutive patients with CoA and VSD underwent repair in our Institute. Single-stage repair was performed in 14 and staged interventional was done in 7 cases (four patient required initial pulmonary artery banding). Median patient’s age was 71.1 days (20-320). Mean VSD size was 5.6 (4.5-8) mm. Preoperative Z-score of aortic isthmus were-4.9 (-5.79 to - 4.75).The follow-up period was 13 (4–31) months.

RESULTS:

Surgery was successful in all patients with no in-hospital mortality or complications reported. No blood infusions were needed in any case. Mean ventilation support time was 19.3 (2-73) h. There were no rhythm or AV conduction disorders. No sternal or rib deformations were observed at the time of discharge, and the small skin incision yielded excellent cosmetic results. Mean hospitalization time was 11.3 (7-18) days.The follow-up Z-score of aortic isthmus0.39 (-0.1 to 0.9).

CONCLUSIONS:

Aorta coarctation repair via left thoracotomy and transventricular VSD closure via ministernotomy is safe and effective technique in newborns and infants.