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CLINICAL STUDY: CONGENITAL HEART DISEASE

Hypothermic circulatory arrest for the surgical treatment of complicated adult coarctation of the aorta

Tomas Gudbjartsson, MD^*, Manu Mathur, MD^*, Tomislav Mihaljevic, MD^*, Lishan Aklog, MD, John G. Byrne, MD, FACC^* and Lawrence H. Cohn, MD, FACC^*,*

^* Division of Cardiac Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, USA
Mount Sinai Hospital, New York, New York, USA

Manuscript received April 8, 2002; revised manuscript received October 10, 2002, accepted November 11, 2002.

^* Reprint requests and correspondence: Dr. Lawrence H. Cohn, Chief, Division of Cardiac Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA.
lcohn{at}partners.org

OBJECTIVES: This study was designed to evaluate the surgical treatment of recurrent coarctation by a new technique.

BACKGROUND: Recurrent coarctation either from aneurysm or recurrent constriction is a difficult problem in the adult because of the possible interruption of important collateral circulation.

METHODS: We reviewed four patients who underwent recurrent coarctation surgery with the use of deep hypothermic circulatory arrest (HCA).

RESULTS: All four patients survived. Deep HCA facilitated precise surgical resection and there was no postoperative paraplegia, stroke, or myocardial infarction.

CONCLUSIONS: Deep HCA and resection and grafting of the coarctation is indicated for complicated adult coarctations, particularly when the collateral circulation is in doubt.

Abbreviations and Acronyms   CPB   cardiopulmonary bypass   HCA   hypothermic circulatory arrest   MRI   magnetic resonance imaging

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