Congenital Malformations of the Aortic Arch with Associated Intra-Abdominal Issues: When to Intervene?

Congenital malformations of the aorta are rare congenital vascular defects. Severe Aortic Coartation (AoCo) and Aortic Arch Interruption (AAI) are aortic anomalies associated with left ventricular outflow tract obstruction and ductal-dependent distal systemic perfusion, requiring early surgical repair. Two neonates, one with severe AoCo and the other with AAI, presented with signs of heart failure and ductal-dependent distal systemic perfusion, and prompt surgery was required. However, other intra-abdominal issues required urgent abdominal surgery. Aortic surgery had to be deferred until the patients were recovered and optimized after the abdominal surgery. Both of the patients had successfully undergone surgical aortic surgery with good results. Timing of surgery for congenital aortic arch anomalies should be weighed according to the patient conditions to ensure a good clinical outcome and to minimize the postoperative morbidity and mortality.