Intermediate term follow-up of the end-to-side aortic anastomosis for coarctation of the aorta

Ann Thorac Surg. 2002 Nov;74(5):1631-4. doi: 10.1016/s0003-4975(02)03902-4.


Background: Classic techniques for repairing coarctation of the aorta, especially in neonates, have a significant incidence of recurrent obstruction. By connecting the descending aorta to the proximal aortic arch, the end-to-side aortic anastomosis isolates hypoplastic distal arch and encroaching ductal tissue from the anastomotic site.

Methods: Follow-up data were available for 88 patients (54 male) who underwent an end-to-side aortic anastomosis from November 1992 until November 1999. The median postoperative follow-up was 1.9 years (range, 0.1 to 6.3 years). Fifty-four patients were corrected as neonates. Thirty-four patients were operated on out of the neonatal period (> 1 month of age). A systolic blood pressure gradient > or = 20 mm Hg and a Doppler flow velocity > or = 2.5 ms across the area of repair were considered a recurrent obstruction.

Results: No patients in the pediatric group had a recurrent obstruction. In the neonatal group, 3 patients (5.5%) had recurrent obstruction. Of those, 2 patients had a reintervention performed; one reintervention was a balloon angioplasty and the other one was a reoperation. Kaplan-Meier analysis of the neonatal group revealed a 95.8% freedom from reintervention at 1 and 2 years.

Conclusions: The end-to-side aortic anastomosis is an effective repair for coarctation of the aorta. Even when performed in the neonatal period, recurrence of coarctation is rare.

MeSH terms

  • Anastomosis, Surgical / methods*
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Aortic Coarctation / diagnostic imaging
  • Aortic Coarctation / surgery*
  • Echocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery
  • Reoperation