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.