The following surgery to repair a coarctation of the aorta is presented through the courtesy of Dr. Redmond Burke, and was carried out at Miami Children’s Hospital, in Miami, Florida.

There is the coarctation. You can see a small crossing vein in the narrowed area of the aorta, right beneath it; that’s the left subclavian artery; vagus nerve; and phrenic nerve.

We’re going to resect the narrowed area of the aorta. You can see right through here, we’re going to go far enough down that we’re in healthy aortic tissue below. We can see the very tight narrowing of the aorta here. So all the blood was going through that tiny orifice.

Placed the stitch in the proximal aorta first, and then on the distal aorta. and I first release the distal clamp, so we’re going to slowly release that. That will tell us if there is any significant bleeding, which we don’t see. And then we’ll slowly release the proximal clamp. Forceps. We usually see a little bit of bleeding from the suture line, through each needle hole. I’m slowly releasing the clamp. Here’s the suture line. The proximal aorta looks good. There is no kinking or twisting and there is no bleeding from the suture line… we feel it, there is no thrill across the aorta any more, and we’ll measure upper and lower blood pressure and see if there is any residual gradient, and then we’ll close the baby up. That’s a coarctation repair resection and end-to-end anastomosis.