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Fig. 1 —Surgical techniques for repair of aortic coarctation. Top row
shows end-to-end anastomosis. Segment containing coarctation is resected, and
proximal and distal aortic segments are apposed directly end to end. Second
row shows subclavian flap procedure. Distal subclavian artery is divided, and
flap of proximal portion of vessel is used to widen segment with coarctation.
Third row shows patch aortoplasty. Elliptic woven Dacron (DuPont) patch is
inserted to expand diameter of lumen. Fourth row shows interposition grafting.
If resected segment of coarctation is too long to allow end-to-end
anastomosis, interposition graft is inserted, creating proximal and distal
anastomoses. Bottom row shows extraanatomic bypass graft. Extraanatomic
ascending aorta-to-descending thoracic aorta bypass grafting is created
through median sternotomy and posterior pericardial approach.
