Aortic dilation is common in patients with congenital heart disease including those
with a bicuspid aortic valve, connective tissue disease, coarctation of the aorta,
and conotruncal defects. In addition, neo-aortic dilation has been described in patients
after aortic reconstruction including the Norwood procedure, the arterial switch operation,
and the Ross procedure. Although aortic catastrophe is rare in patients with congenital
heart disease, common pathologic endpoints in these patients likely manifest with
similar aortic tissue behavior. A lifelong care model with similar indications for
surveillance and prophylactic repair to other more common aortopathies is therefore
warranted. Still, reoperative aortic arch reconstruction in these patients is often
a complex and high-risk endeavor, and in all cases, a tailored and adaptable plan
ensuring adequate myocardial and cerebral protection with appropriate rescue measures
is paramount. A surgical team taking on these challenging cases should possess an
armamentarium of open, hybrid, and endovascular techniques which can be individualized
to a patient's unique anatomy, surgical history, and concomitant lesions as well as
the team's measured outcomes and experience.
Keywords
Abbreviations:
B-SAFER (Branched stented anastomosis frozen elephant trunk repair), MATADORS (Multidisciplinary Study of Ascending Tissue Characteristics and Hemodynamics for the Development of Novel Aortic Stentgrafts)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 02, 2023
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