SUCCESSFUL REPAIR OF RECURRENT COARCTATION AFTER NEONATAL HEART-TRANSPLANTATION

Neonatal orthotopic heart transplantation is an attractive primary sur gical therapy for severe uncorrectable congenital heart defects such a s variants of the hypoplastic left heart syndrome. Aortic arch reconst ruction is frequently required to repair the hypoplastic aortic arch a nd the coarctation at the time of graft implantation. Residual coarcta tion of the aorta after neonatal heart transplantation for such a cond ition has satisfactorily been treated with percutaneous balloon dilata tion. We describe the successful surgical repair of a recurrent coarct ation of the aorta via a sternotomy in a 2-year-old patient who had pr eviously undergone neonatal orthotopic heart transplantation. Postoper ative periodic investigations have not shown any evidence of obstructi on across the site of the primary end-to-end anastomosis.