Introduction
Aortic arch hypoplasia (AAH) involving all segments of the arch, usually
occurs in neonate and infants with intra-cardiac anomalies1–3. Discrete aortic coarctation is rare in infantile
period, and up to 31% of these patients have associated with some
degree of aortic arch hypoplasia (AAH) 1. Although
there are still no definite diagnostic criteria, AAH is generally
considered present, when the aortic arch diameter between the innominate
artery and the left common carotid artery is <60%, between
the left common carotid artery and the left subclavian artery is
<50%, and the aortic isthmus is <40% of the
ascending aorta diameter1. Surgical management of
aortic arch hypoplasia is a surgical challenge. Associated intra-cardiac
pathologies are present with varying severity ranging from a simple
ventricular septal defect to hypoplastic left heart syndrome, that may
affect the decision making and outcomes. There are also great diversity
in the surgical repair techniques myocardial, and cerebral protection
strategies. Moreover, postoperative recurrent aortic arch obstruction
remains a significant problem in mid-to long term3,4.
Decision making between single stage repair or staged approach is not
only depend on the intracardiac anomaly, but also patients’ general
condition and surgeons’ preference. In the current study, we reviewed
our early and mid-term results in neonates and infants with aortic arch
hypoplasia and intracardiac anomalies in terms of single stage or staged
repair.