An Innovative Technique for the Repair of Long-Segment Juxtaductal Coarctation of the Aorta in Neonates and Infants

An extra-cardiac anomaly known as coarctation of the aorta (CoA) is characterized by intraluminal constriction that impedes forward blood flow. The most typical location is close to the ductus arteriosus, immediately distal to the left subclavian artery. Blood flow obstruction is typically caused by a "shelf-like" tissue that protrudes from the posterior aortic wall into the aortic lumen. Long-segment juxtaductal CoA with cardiac dysfunction is a surgical priority. End-to-end anastomosis of long-segment juxtaductal CoA leads to a considerable gradient across the segment even after extensive mobilization. Addition of a subclavian flap along with the end-to-end anastomosis of the posterior layer of the aorta is an achievable, physiologic, and feasible procedure.