Bovine Aortic Arch Shortens Available Clamping Distance for Extended End-to-End Repair of Infant Coarctation of the Aorta

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Midwest Pediatric Cardiology Society




Bovine aortic arch is an anatomical variant in which the innominate and left common carotid arteries share a common origin. It is generally considered to be benign. The current literature estimates its prevalence may be as high as 30%. Coarctation of the aorta is a congenital heart defect characterized by narrowing of the aortic arch, usually near the insertion of the ductus arteriosus. Untreated coarctation of the aorta can lead to hypertension, poor perfusion of the lower extremities, and left ventricular hypertrophy and failure. Resection with extended end-toend anastomosis from a left thoracotomy remains the standard of care in the absence of arch hypoplasia. Extended end-to-end anastomosis requires the placement of a proximal clamp just distal to the innominate artery and a distal clamp on the descending aorta. The distance between the proximal clamp and the coarctation represents the amount of vessel the surgeon has available for reconstructing the aorta with this technique. The goal of this study is to determine if bovine aortic arch anatomy affects the clamping distance.


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