![]() ![]() The procedure yielded minimal intraoperative blood loss and enabled complete postoperative recovery without any sequelae. We repaired our patient's IAA in a single stage with a 16-mm Dacron graft. Ventral aortic repair through a midline approach-the preferred technique for repairing IAA in adult patients-avoids damaging the extensive network of collateral vessels and in all likelihood reduces the risk of morbidity and death. Follow-up examinations have revealed good graft patency. 8–16 In no case have neurologic, renal, or gastrointestinal complications, re-interventions, or in-hospital or late deaths been noted. In adults, IAA has typically been repaired in a single stage by means of an extra-anatomic approach. We hypothesize that these adult patients actually had a severe form of aortic coarctation that transformed into an interruption-which would mean that the adult form of aortic interruption is altogether different from the neonatal form. ![]() Infants with IAA typically have an associated VSD, 6 whereas adults do not and type B interruption is prevalent in infants, 6 whereas type A interruption has been reported most often in adults. These patients can later present with features of systemic hypertension and have what is called the adult form of IAA.ĭifferences exist between the neonatal and adult forms of IAA. ![]() 6,7 It is not known what causes these collateral vessels to form so early in life. In neonatal IAA, substantial collateral circulation must be present to enable survival to adulthood, 1 and some neonates with IAA develop collateral vessels that maintain blood flow to the distal aorta. 5 In these instances, the presentation ranged from no symptoms to swollen limbs with higher blood pressures in the upper limbs than in the lower limbs. A massive collateral network, predominantly through the internal mammary and intercostal arteries, ensured circulation to the hypoplastic distal aorta (Figure 3. As of 2010, investigators had identified only 30 cases of isolated IAA in adults in the world medical literature. ![]()
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