AORTIC OBSTRUCTIONS IN INFANTS AND CHILDREN - SURGERY FOR INTERRUPTEDAORTIC-ARCH

Interruption of the aortic arch, a severe form of congenital obstructi on of the aorta, is highly lethal if not treated. Over the past four d ecades, many advances in surgical technique have resulted in markedly improved survival rates for this defect. The preoperative clinical con dition of most patients can be improved by intensive medical managemen t with mechanical ventilation, inotropic support, and prostaglandin in fusion. In recent years, there has been an increasing interest in and success with complete primary repair in infancy as the technique of ch oice. Various forms of palliative operative techniques have fair to po or results. A two-stage approach, however, with initial arch repair ac companied by pulmonary artery banding, and a subsequent repair of the intracardiac lesion, can be performed in special circumstances. Recurr ent stenosis at the aortic suture line can be treated by either reoper ation or balloon angioplasty.