Coarctation and hypoplasia of the aortic arch: Will the arch grow?

Ralph D. Siewers*, Jose Ettedgui, Elfrede Pahl, Terry Tallman, Pedro J. del Nido

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


Hypoplasia of the transverse aortic arch of various degrees of severity is commonly seen in infants who have coarctation of the aorta. It is more often present when the coarctation is associated with intracardiac lesions that diminish or limit forward flow in the ascending aorta and promote right to left flow through an arterial duct. The increased frequency of surgical treatment of infants with complex coarctation, which is in part related to the ability to stabilize their condition with prostaglandin E1, has posed the question of the potential for growth and development of the originally hypoplastic aortic arch after conventional repair of aortic coarctation. Review of our experience with transverse aortic arch hypoplasia, found in 33 (32%) of 102 infants undergoing coarctation repair by subclavian flap aortoplasty or classic resection and end-to-end anastomosis, revealed excellent growth of the transverse arch after repair in all patients available for linear follow-up. The currently proposed extended arch repair should be reserved for the small group of infants with transverse aortic arch to ascending aorta diameter ratios (arch indices) of less than 0.25.

Original languageEnglish (US)
Pages (from-to)608-613
Number of pages6
JournalThe Annals of thoracic surgery
Issue number3
StatePublished - Sep 1991

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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