Abstract
Objective. Treatment of infants with obstructive pathology of the aortic arch and associated VSD still represents a challenge.
Material and methods. In our study, we describe the experience in treating children with this pathology with the use of different surgical
strategies: in Group I was included 48 children who underwent single-stage correction of associated defects; group II included
16 children who underwent a two-stage treatment, including the elimination of the obstruction of the aortic arch and pulmonary artery
(PA) banding at the time of primary intervention and closure of VSD with the PA band removal in the long term. Both groups at the
time of first intervention were comparable with mean age of 30.79 days (2 to 143), and 26.58 days (2 to 88) and mean weight
3,45 ± 0,74 (2.0-5,6) and 3,57 ± 0,71 (2,2-5,4); weight < 2.5 kg was observed in 7 (14.5%) and 1 (6.25%), respectively. In group I,
operations were performed through a median sternotomy. In two-stage strategy group at the first operation carried out reconstruction of the arc through lateral thoracotomy, which was supplemented by the pulmonary artery banding. The second stage of surgery
at the age of 4,57 ± 1,48 months included the closure of the VSD and PA plasty.
Results. The results showed the absence of in-hospital mortality in both groups over the past nine years. Low body weight of the child
at the time of surgery was not a risk factor for adverse outcome.м
Conclusion. Based on the results, in the absence of severe somatic pathology, we believe the preferred single-stage strategy correction of aortic arch obstruction and associated VSD.
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