Asian Cardiovasc Thorac Ann 2003;11:250-254
© 2003 Asia Publishing EXchange Ltd
One-Stage Repair of Cardiac and Arch Anomalies Without Circulatory Arrest
Kona Samba Murthy, MCh,
Robert Coelho, MCh,
Christopher Roy, MCh,
Snehal Kulkarni, DNB,
Benjamin Ninan, MD,
Kotturathu Mammen Cherian, FRACS
Institute of Cardiovascular Diseases, Madras Medical Mission, Mogappair, Chennai, India
For reprint information contact: Kona Samba Murthy, MCh Tel: 91 44 2656 5961/5968 Fax: 91 44 2656 5859 email: konasmurthy{at}hotmail.com Institute of Cardiovascular Diseases, Madras Medical Mission, 4A Dr. JJ Nagar, Mogappair, Chennai 600 050, India.
Between 1999 and 2002, 23 patients underwent single-stage complete repair of cardiac anomalies and aortic arch obstruction, without circulatory arrest. Median age was 1.2 years. Intracardiac defects included ventricular septal defect in 9, double-outlet right ventricle in 6, d-transposition of the great arteries and ventricular septal defect in 2, subaortic obstruction in 3, and atrial septal defect in 3. Fourteen patients had coarctation of the aorta, 6 had coarctation with hypoplastic aortic arch, and 3 had interrupted aortic arch. Simple techniques were employed such as cannulation of the ascending aorta near the innominate artery and maintaining cerebral and myocardial perfusion. After correction of arch obstruction, intracardiac repair was undertaken. The mean cardiopulmonary bypass time was 169 min, aortic crossclamp time was 51 min, and arch repair took 16 min. There was no operative mortality or neurological deficit. In follow-up of 1–43 months, no patient had residual coarctation. This simplified technique avoids additional procedures, reduces ischemic time, and prevents problems related to circulatory arrest.
Copyright © 2003 by the Asia Publishing EXchange Ltd.
