LATE OUTCOMES OF SURGICAL REPAIR OF DISTAL AORTIC ARCH HYPOPLASIA: PROSPECTIVE RANDOMIZED STUDY
Aim of the study - to compare the results of different surgical approaches through repair of the aorta coarctation with distal aortic arch hypoplasia. Material and methods. 54 patients underwent surgical treatment of the aorta coarctation took part in this pilot randomized study. Patients were divided in two groups: modified reverse subclavian flap aortoplasty (I group, 27 pts) and extended «end-to-end» anastomosis technique (II group, 27 pts). Results. In-hospital mortality was 3.7 % in each group. Recoarctation of the aorta in the late follow-up period was developed in 1 patient from group I (3.84 %) and in 2 patients from group II (7.7 %) ( p = 0.5). Two patients from group I had aneurysms of the distal aortic arch ( p = 0.15). Arterial hypertension was developed in 2 patients underwent modified reverse aortoplasty (7.7 %) and in 8 patients underwent extended anastomosis (30.8 %) ( p = 0.03). Conclusions. Modified reverse subclavian flap aortoplasty and extended «end-to-end» anastomosis have no significant differences in morbidity and rate of early postoperative complications. Nevertheless, using of modified reverse aortoplasty allows reducing the rate of arterial hypertension development in midterm period, however there is a potential risk of development of the aneurysm of distal aortic arch, which may require further study.