Document Detail

Extraanatomic thoracic aortic bypass grafts: indications, techniques, and results.
MedLine Citation:
PMID:  9030807     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Even in the age of extensive aortic replacement special circumstances may warrant the insertion of extraanatomic thoracic aortic bypass grafts. Our experience with 17 patients is analyzed. METHODS: Between 1988 and 1994, ten female and seven male patients (mean age 37.5 years, range 9-69 years) were treated for the following indications: (1) complex CoA (n = 5); (2) reoperation for CoA (n = 6); (3) extensive aortic occlusive disease (n = 4); and (4) complicated aneurysm (n = 2). Routing of the grafts was: ascending-descending aorta (8); ascending-abdominal aorta (4); left subdavian artery- descending aorta (2); descending-descending aorta (2); and descending-abdominal aorta (1). Eight procedures were reoperations. In four patients concomitant cardiac operations were performed: one aortic valve replacement, one patch plasty of the LCA, and two composite graft replacements of aortic valve and ascending aorta, one of them with CABG. RESULTS: Three early deaths occurred. two after emergency operation in thoracic aneurysm under dire conditions (one perforation, one infection), one after ascending-abdominal aortic grafting with multiple branch revascularization. The underlying pathology was relieved successfully in all 14 survivors. In the two patients with concomitant aortic valve and isthmic stenosis, critical anterior motion of the mitral valve, presumably because of the massive afterload reduction of the left ventricle, complicated the perioperative course. One patient was reoperated because of aneurysm 4 years after descending-descending aortic grafting for complex CoA with poststenotic dilatation. CONCLUSIONS: In complex aortic coarctation or hypoplasia extraanatomic bypass grafts are expedient and effective procedures, especially for reoperation. Their use in the treatment of aneurysmal lesions remains an exception.
M K Heinemann; G Ziemer; T Wahlers; A Köhler; H G Borst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  11     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-05-07     Completed Date:  1997-05-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  169-75     Citation Subset:  IM    
Department of Thoracic and Cardiovascular Surgery, Surgical Center, Hannover Medical School, Germany.
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MeSH Terms
Aortic Aneurysm, Thoracic / mortality,  radiography,  surgery*
Aortic Coarctation / mortality,  radiography,  surgery*
Aortic Diseases / mortality,  radiography,  surgery*
Arterial Occlusive Diseases / mortality,  radiography,  surgery*
Blood Vessel Prosthesis*
Cause of Death
Image Processing, Computer-Assisted
Middle Aged
Postoperative Complications / mortality,  radiography,  surgery
Prosthesis Design
Prosthesis Failure
Survival Rate
Tomography, X-Ray Computed

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