The Pediatric Cardiac Surgery Inquest Report



Interrupted aortic arch

In this condition, the aorta does not develop completely in the area of the arch. As a result, the aorta is divided into two parts that are not connected to each other. This prevents the flow of blood through the aorta. Because blood flow through the aorta is blocked, the blood supply to the lower body is compromised. At birth, the open ductus arteriosus allows blood to flow from the right ventricle to the lower body. There are often other coexisting heart defects, such as a VSD.

Interrupted aortic arch is usually diagnosed when the ductus arteriosus begins to close. With decreasing circulation to the lower body, serious damage can occur to the liver, kidneys and intestines. Prostaglandin is given to keep the ductus arteriosus open until surgery is performed, usually as soon after birth as possible.

Most often a one-stage repair is undertaken, patching the arch or connecting the two ends of the aortic arch together, closing any VSD, and tying off and dividing the ductus arteriosus into two parts.


Diagram 2.10 - interrupted aortic arch
Diagram 2.10 Interrupted aortic arch
1 - interruption of aortic arch
2 - descending aorta connected to pulmonary artery by large patent ductus arteriosus
3 - ventricular septal defect
Flow patterns are normal to the upper body. However, there is no flow of oxygenated blood to the lower body unless there exist, as in this drawing, shunts such as a ventricular septal defect that allows oxygenated blood into the pulmonary artery, and a patent ductus arteriosus that allows the partially oxygenated blood to travel from the pulmonary artery to the descending aorta (as indicated by the broken white arrow).



Current Home - Table of Contents - Chapter 2 - Interrupted aortic arch
Next Pulmonary stenosis and aortic stenosis
Previous Coarctation of the aorta
Section 1 Chapter 1 - Introduction to the Issues
  Chapter 2 - Pediatric Cardiac Issues
  Chapter 3 - The Diagnosis of Pediatric Heart Defects and their Surgical Treatment
  Chapter 4 - The Health Sciences Centre
Section 2 Chapter 5 - Pediatric Cardiac Surgery in Winnipeg 1950-1993
  Chapter 6 - The Restart of Pediatric Cardiac Surgery in 1994
January 1, 1994 to May 17, 1994
  Chapter 7 - The Slowdown
May 17 to September 1994
  Chapter 8 - Events Leading to the Suspension of the Program
September 7, 1994 to December 23, 1994
  Chapter 9 - 1995 - The Aftermath of the Shutdown
January to March, 1995
Section 3 Chapter 10 - Findings and Recommendations
Appendix 1 - Glossary of terms used in this report
Appendix 2 - Parties to the Proceedings and counsel
Appendix 3 - List of witnesses and dates of testimony
Search the Report
Table of Contents