Anastomosis of the Subclavian Artery to the Distal Aorta for Management of Coarctation of the Aorta

Contrary to current concepts reported in the literature, it has been our experience that anastomosis of the divided left subclavian artery to the distal aorta is a suitable form of correction for adult-type aortic coarctation. For such therapy the lumen size of the subclavian artery should be adequate and the proximal end of the coarctation must be in close proximity to the base of the subclavian artery. Comparison of arm arterial pressure changes between one and nine years after operation indicates no significant difference between subclavian artery anastomoses and direct aorto-aortic anastomoses when the selection of patients is proper. By use of this maneuver, it is possible on occasion to avoid the use of homologous tissue grafts or plastic prostheses, the late effects of which are not known at present.