Abstract
Background: Surgical approach for coarctation or interruption of the aorta（ CoA/IAA） with complex cardiac anomalies consists of single or staged repair. Our strategy has advocated staged repair, including arch repair and pulmonary artery banding without the use of extracorporeal circulation as the first palliation. For cases of low birth weight and hypoplastic aortic arch，we have performed bilateral pulmonary banding as the first palliation.
Objective and Methods: Between 1996 to 2009，17 neonates and infants with CoA/IAA associated with complex cardiac anomalies underwent surgery at our institution. We assessed the surgical results.
Results: Univentricular repair was done for 10 patients and biventricular repair for 7 patients. In univentricular group，all patients survived the first palliation，and the Fontan operation was achieved in 8 patients so far. The remaining 2 patients are waiting for the Fontan operation. All 7 patients with biventricular repair survived the first palliation as well，and achieved definitive operation with 2 early deaths. The Damus-Kaye-Stansel procedure or myectomy was carried out for 8 patients with anatomical or functional subaortic stenosis，and postoperative balloon angioplasty was carried out for 3 patients including 1 with significant stenosis.
Conclusion: Although a staged surgical approach for CoA/IAA with complex cardiac anomalies often required additional intervention，this approach had good results. A staged repair consisting of bilateral pulmonary artery banding as the first palliation would be a useful choice for these anomalies with low birth weight and a hypoplastic aortic arch.
