Interrupted aortic arch and ventricular septal defect. Direct repair through a median sternotomy incision in a 13-day-old infant.

A type B interrupted aortic arch was successfully repaired in a 13-day-old infant during profound hypothermia and circulatory arrest. Through a median sternotomy incision it was possible to resect a patent ductus arteriosus and mobilize the descending thoracic aorta for anastomosis to the side of the ascending aorta. At the same time a large ventricular septal defect (VSD) and a small atrial septal defect were closed through the right atrium. Cardiac catheterization 5 months after operation showed a small persistent VSD with a pulmonary to systemic blood flow ratio of 1.1/1. The systolic gradient between the ascending and descending aorta was 20 mm. Hg.