Posterior Plication of the Ascending Aorta to Relieve Tracheal Compression after Aorto-Left Ventricular Tunnel Repair

Sho Isobe＊	Koji Nomura＊	Yoshihiro Ko＊
Fumiaki Murayama＊

（Department of Cardiovascular Surgery, Saitama Children’s Medical Center＊, Saitama, Japan）

A nine-month-old boy with a prenatal diagnosis of aorto-left ventricular tunnel（ALVT）and aortic valve disease underwent an urgent ALVT patch closure approximately 2h after birth. The patient subsequently developed airway compression due to the progressive dilatation of the ascending aorta postoperatively associated with aortic regurgitation and stenosis. After 9 months of prolonged respiratory symptoms following the ALVT repair, he underwent a posterior plication of the ascending aorta. After plication, the tracheal compression and respiratory symptoms improved. A computed tomography（CT）scan 1 month after surgery revealed significant free space between the aorta and the trachea, which relieved the aortic compression. Posterior plication of the ascending aorta is achieved by resecting the posterior aortic wall adjacent to the airway. It is the procedure of choice for longer and more effective relief of airway compression compared to other procedures such as anterior aortopexy, the lateral sliding technique, and side clamp plication.

 

Jpn. J. Cardiovasc. Surg. 49:192-195（2020）

Keywords：posterior plication;ascending aorta;tracheal compression;tracheomalacia