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Soynov IA, Arkhipov AN, Manukian SN, Kulyabin YY, Kobelev E, Malakhova OY, Voitov AV, Suzdalova OA. Biventricular repair in low-weight patient with interrupted aortic arch and aortic atresia. Egypt Heart J 2024; 76:84. [PMID: 38965125 PMCID: PMC11224169 DOI: 10.1186/s43044-024-00516-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Aortic atresia with ventricular septal defect is a very rare congenital cardiac anomaly, especially in combination with aortic arch interruption. It is always challenging to choose the optimal treatment tactics for such patients. One of the possible types of intervention is the Yasui procedure. There are only 19 reported cases in the literature of aortic atresia with interruption of the aortic arch type B or C, and not a single clinical case of type A. CASE PRESENTATION The proband was a 2-day-old boy with diagnosis: aortic atresia with a ventricular septal defect and interruption of the aortic arch type B. The child underwent a Yasui procedure without serious postoperative complications and with good long-term result. CONCLUSIONS The Yasui procedure in patients with aortic atresia and interrupted aortic arch can be performed with minimal complications, even in low-weight patients.
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Affiliation(s)
- Ilya A Soynov
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055.
| | - Alexey N Arkhipov
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
| | - Serezha N Manukian
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
| | - Yuriy Y Kulyabin
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
| | - Evgeniy Kobelev
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
| | - Oksana Y Malakhova
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
| | - Alexey V Voitov
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
| | - Olga A Suzdalova
- Department of Pediatric Cardiac Surgery, E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Rechkunovskaya Str. 15, Novosibirsk, Russia, 630055
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Howell AJ, Argo MB, Barron DJ. Aortic Atresia or Complex Left Outflow Tract Obstruction in the Presence of a Ventricular Septal Defect. World J Pediatr Congenit Heart Surg 2022; 13:624-630. [PMID: 36053110 PMCID: PMC9442629 DOI: 10.1177/21501351221114881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Severe left outflow tract obstruction (LVOTO) is not always associated with hypoplastic left heart syndrome (HLHS). Aortic valvar atresia or complex LVOTO in the presence of a large ventricular septal defect (VSD) are a rare group of lesions that offer the possibility of biventricular repair. The Yasui procedure is the commonest surgical approach which can be performed as a primary neonatal correction or as a staged procedure with a Norwood followed by a subsequent Rastelli. This article reviews the surgical outcomes and decision-making process. Both strategies are reasonable with the trend toward staged procedure in the setting of the additional interrupted arch, with neonatal survival of > 90% in the modern era and excellent long-term survival. Re-intervention is mostly related to conduit revision and the need for re-operation for LVOTO is rare. Deciding between conventional repair and the Yasui in cases of LVOTO/VSD can be difficult and there are no uniform accepted criteria. In a typical neonate, an aortic annulus < 4.5 mm is generally the limit of acceptability for a conventional repair. In selected cases of LVOTO/VSD, an alternative to the Yasui is the Ross-Konno. Retrospective comparisons between the 2 techniques are difficult due to differing patient characteristics (especially associated with mitral valve disease) but the neonatal Ross has been associated with higher early mortality.
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Affiliation(s)
- Allison J Howell
- Labatt Family Heart Centre, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Madison B Argo
- Labatt Family Heart Centre, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - David J Barron
- Labatt Family Heart Centre, 7979Hospital for Sick Children, Toronto, Ontario, Canada
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