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Is surgery necessary for adults with Isolated Interrupted Aortic Arch?: Case series with literature review
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  • Yefan Jiang,
  • Chen Wang,
  • Xionggang Jiang,
  • Si Chen
Yefan Jiang
Huazhong University of Science and Technology

Corresponding Author:xwkjyf@hotmail.com

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Chen Wang
Huazhong University of Science and Technology
Author Profile
Xionggang Jiang
Huazhong University of Science and Technology
Author Profile
Si Chen
Huazhong University of Science and Technology
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Abstract

Background and Aim: Interrupted aortic arch (IAA) is defined as a complete interruption of aortic lumen between the ascending and descending aorta. It is an uncommon and complicated congenital heart disease with high mortality in infants. It is rare for patients with isolated IAA to survive to adulthood without operation unless the extensive collateral vessels joining the descending aorta. Here we present three unique cases with isolated IAA together with a review of the literature. Methods: case presentation: We retrospectively searched the hospital patient databases for patients (>14 years) with IAA diagnosed at the Wuhan Union Hospital over the past 10 years and excluded the patients with other cardiac malformations. Three patients were identified. Two were referred to us for hypertension management and were diagnosed with IAA at our hospital. They both declined surgical treatments and underwent conservative therapy including management of their hypertension. One patient was referred to our hospital for further treatment options after the patient was diagnosed with IAA at another hospital. This patient received an extra-anatomic bypass surgery from ascending aorta to descending aorta. His high blood pressure did not resolve and was subsequently managed by anti-hypertensives medications after the surgery. Discussion and conclusions: Adult patients with isolated IAA usually have extensive collateral vessels joining the descending aorta. Surgical intervention may not be necessary for these patients if the patients have no symptoms except hypertension. Anti-hypertensives medical management with long term follow-up appears to be a reasonable treatment option for these patients.
12 Sep 2020Submitted to Journal of Cardiac Surgery
12 Sep 2020Submission Checks Completed
12 Sep 2020Assigned to Editor
14 Sep 2020Reviewer(s) Assigned
25 Sep 2020Review(s) Completed, Editorial Evaluation Pending
25 Sep 2020Editorial Decision: Revise Major
13 Nov 20201st Revision Received
13 Nov 2020Submission Checks Completed
13 Nov 2020Assigned to Editor
15 Nov 2020Reviewer(s) Assigned
04 Dec 2020Review(s) Completed, Editorial Evaluation Pending
04 Dec 2020Editorial Decision: Revise Major
03 Jan 20212nd Revision Received
04 Jan 2021Submission Checks Completed
04 Jan 2021Assigned to Editor
07 Jan 2021Reviewer(s) Assigned
18 Jan 2021Review(s) Completed, Editorial Evaluation Pending
18 Jan 2021Editorial Decision: Revise Minor
28 Jan 20213rd Revision Received
01 Feb 2021Submission Checks Completed
01 Feb 2021Assigned to Editor
01 Feb 2021Reviewer(s) Assigned
10 Feb 2021Review(s) Completed, Editorial Evaluation Pending
10 Feb 2021Editorial Decision: Accept
Jul 2021Published in Journal of Cardiac Surgery volume 36 issue 7 on pages 2467-2475. 10.1111/jocs.15525