Neonatal patients with hypoplasia of the aortic arch constitute a heterogeneous group with a wide spectrum of severity. The milder end of the spectrum comprises patients with aortic coarctation and isthmus hypoplasia. At the other end of the spectrum are patients with severe transverse arch hypoplasia or hypoplastic left heart syndrome. The aim of this paper is to discuss the various strategies and surgical approaches available for this group of patients, focusing on the surgical decisions that influence individual patient management. Many of the things discussed are applicable to any neonatal arch problem. We also describe and discuss in detail our surgical technique for patients who undergo neonatal repair of a hypoplastic aortic arch via median sternotomy.
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From the Section of Pediatric and Congenital Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health & Science University.
Dr Langley reports receiving lecture fees from CorMatrix. Authors Sunstrom, Reed, Rekito, and Gerrah have no commercial interests to disclose.
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.