Coarctation repair: modification of end-to-end anastomosis with subclavian flap angioplasty.

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.

Valve repair for aortic insufficiency: surgical classification and techniques.

Objective: Valve repair for aortic insufficiency may provide an alternative to aortic valve replacement in selected patients. This repair could be an attempt at permanent correction or palliation to allow the aortic annulus to grow and avoid the use of anticoagulation. Based upon a five-year experience, we proposed a classification according to valvular anatomy which could be a guide to patient and procedure selection.

Anterior pulmonary translocation for repair of truncus arteriosus with interrupted arch.

A newborn was found to have truncus arteriosus and an interrupted aortic arch, and underwent primary repair. The patient did well initially, but, by 8 weeks postoperatively, showed evidence of severe compression of the right pulmonary artery. At reoperation, the pulmonary artery was found to be compressed by a large aortic root (truncal root) and the retroaortic area was narrowed.