Anastomosis of the subclavian artery to the distal aorta for management of coarctation of the aorta.

T HE CLASSIC EXPERIMENTAL AND CLINical work of Gross and Hufnagel’ on coarctation of the aorta demonstrated the feasibility of direct end-to-end anastomosis of the proximal to the distal aorta for management of the usual type of coarctation in the adult. They pointed out that the anatomic configuration of thecoarctation could be such that considerable mobilization of the aorta would be necessary to re-establish aortic continuity if a long segment of coarctation had to be resected. The problem of bridging very long defects was solved in 19492.3 by the introduction of homologous aortic grafts. An improved technique for the sterilization and preservation of such homologous arterial grafts was introduced by Meeker and Gross4 in 1951.