Repair of Aortic Coarctation With Curved Bovine Pericardial Patch

Repair of aortic coarctation in infants and small children is associated with high rates of reintervention due to recurrent coarctation and other aortic pathologies [1]. Use of a curved, geometrically optimized patch during extensive aortic reconstruction may decrease the risk of re-coarctation by minimizing kinking and anastomotic torsion. This video captures the conduct of a successful aortic coarctation repair with a curved patch in a previously healthy 16-month-old male found to have extensive aortic coarctation as well as long segment narrowing of the aortic isthmus. Post-bypass TEE showed no evidence of arch obstruction. The patient had a short post-operative hospital stay and was discharged to home on post-operative day 5. In conclusion, use of a curved pericardial patch is feasible for aortic reconstruction in infants and small children. Curved patch geometry may have advantages, such as avoidance of kinks and folds, when extensive arch augmentation is necessary but further investigation into long-term outcomes is warranted.

Reference

1. Roos-Hesselink JW, Schölzel BE, Heijdra RJ, et al. Aortic valve and aortic arch pathology after coarctation repair. Heart. 2003; 89(9):1074-7.

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