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Hybrid Surgical Repair for Recurrent Coarctation of the Transvers Arch: Case Report
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  • Kıvanc ATILGAN,
  • Alper TOSYA,
  • Fahri YEŞİL,
  • Pinar Koksal Coskun,
  • Burak ONUK,
  • Tayfun Aybek
Kıvanc ATILGAN
Gulhane Military Medical Academy, School of Medicine
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Alper TOSYA
Koç University Graduate School of Health Sciences
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Fahri YEŞİL
TOBB ETU Hospital
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Pinar Koksal Coskun
TOBB-ETU Hospital
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Burak ONUK
TOBB ETU Hospital
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Tayfun Aybek
TOBB-ETU Hospital
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Abstract

The incidence of postoperative recurrent coarctation of the aorta ranges from 5% to 50%, and largely depends on the age at initial repair. Due to the increased fibrosity and rigidity of the aorta in older age, stent placement is preferred instead of balloon angioplasty, resulting in an almost complete relief of the gradient in >95% of the patients. In patients with transverse arch hypoplasia, transcatheter intervention with further surgical intervention may be needed, and the use of stenting was shown to be effective in the treatment of patients with hypoplastic isthmus, arch or tubular coarctation. In this case of a late re-coarctation, we preferred to apply a hybrid technique for treatment. The first step of the treatment was debranching of the brachiocephalic and left common carotid arteries with upper mini median sternotomy. On the following day, the patient underwent a successful stent placement to the transvers arch.