Abstract
Recurrent coarctation of the aorta in patients with hypoplastic left heart syndrome requires timely intervention to limit ventricular dysfunction and atrioventricular valve regurgitation. Current strategies include catheter-based intervention in adequately sized patients or surgical arch augmentation at the time of a concomitant operation. We report an open-hybrid surgical technique with placement of a balloon-expandable stent that can later be expanded to an adult size as the patient grows. Limiting the arch dissection reduces the risk to the left recurrent laryngeal nerve and shortens anterograde cerebral perfusion time.