Management of recurrent coarctation of the aorta: a new experimental technique.

A new technique is described for the management of recurrent coarctation of the aorta. It involves enlarging the narrowed segment by an onlay patch sutured to the adventitia and outer media of the aortic wall. The procedure was used in 6 mongrel dogs with preexisting surgically created coarctation. Aortic cross-clamping time ranged between 7.5 and 11 minutes (mean, 8.8 +/- 1.3 minutes). There were no operative deaths or complications. Gross and microscopic examination of the aorta 6 to 12 months (mean, 9 +/- 2.2 months) postoperatively revealed a 290 to 380% (mean, 350 +/- 30%) increase in the diameter of the repaired area and no evidence of thrombosis or pseudoaneurysm formation. The need for minimal dissection and the brief period of aortic cross-clamping make this approach an attractive alternative in the surgical treatment of patients with difficult cases of recoarctation.