caa a22 4500 47575364X CHVBK 20180406123531.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s005950070092 doi (NATIONALLICENCE)springer-10.1007/s005950070092 Surgical treatment for graft stenosis after repair of an interrupted aortic arch: Report of two cases [Elektronische Daten] [Tomokazu Kosuga, Shuji Fukunaga, Koji Akasu, Shingo Chihara, Shogo Yokose, Hidetoshi Akashi, Takemi Kawara, Ken-ichi Kosuga, Shigeaki Aoyagi] We report herein two cases of patients who underwent successful reoperation for graft stenosis after repair of an interrupted aortic arch (IAA). The first patient was a 10-year-old girl who suffered from upper limb hypertension 9 years after her initial operation. Cardiac catheterization revealed a pressure gradient of 55mmHg across the repaired arch. At reoperation, a left subclavian turndown anastomosis was performed, following which the hypertension resolved and a cardiac catheterization done 5 years later demonstrated sufficient growth of the restored arch with no significant gradient. The second patient was a 17-year-old boy who suffered from general fatigue and intermittent hypertension 12 years after his initial operation. Cardiac catheterization revealed a gradient of 60mmHg across the repaired arch. He underwent an extraanatomic ascending to descending aortic bypass employing an additional 18-mm graft, and a postoperative cardiac catheterization showed no gradient between the ascending and descending aorta. Our experience has shown that IAA should be repaired without prosthetic grafts if possible. Although extraanatomic bypass is useful for reducing the operative risks at reoperation, a large graft should be used to avoid the need for a third operation. For young children expected to outgrow a second graft, performing an endogenous anastomosis, such as a left subclavian turndown anastomosis, should be considered as an alternative. Springer-Verlag, 2000 Interrupted aortic arch nationallicence Graft stenosis nationallicence Reoperation nationallicence Left subclavian turndown anastomosis nationallicence Extraanatomic aortic bypass nationallicence Kosuga Tomokazu Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Fukunaga Shuji Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Akasu Koji Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Chihara Shingo Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Yokose Shogo Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Akashi Hidetoshi Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Kawara Takemi Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Kosuga Ken-ichi Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Aoyagi Shigeaki Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut Surgery Today Springer-Verlag 30/8(2000-08-01), 754-758 0941-1291 30:8<754 2000 30 595 https://doi.org/10.1007/s005950070092 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950070092 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kosuga Tomokazu Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Fukunaga Shuji Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Akasu Koji Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Chihara Shingo Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Yokose Shogo Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Akashi Hidetoshi Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Kawara Takemi Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Kosuga Ken-ichi Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 700 1- Aoyagi Shigeaki Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, 830-0011, Kurume, Japan aut NATIONALLICENCE 773 0- Surgery Today Springer-Verlag 30/8(2000-08-01), 754-758 0941-1291 30:8<754 2000 30 595 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer