Document Detail


Long-term results of ascending aorta-abdominal aorta extra-anatomic bypass for recoarctation in adults with 27-year follow-up.
MedLine Citation:
PMID:  18657989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The surgical treatment of recurrent coarctation in adults supposes a redo left thoracotomy with adhesions and high risk of bleeding and injury of adjacent nerves. The rate of paraplegia in these cases may reach 2.6%. Extra-anatomic aortic bypass avoids these complications. We present our results with ascending-to-abdominal aorta extra-anatomic bypass for recurrent aortic coarctation in adults. METHODS: Between September 1979 and November 2006 12 patients underwent ascending-to-abdominal aorta bypass. There were 10 males and 2 females. Mean age was 36.2+/-11.3 (range 21-57) years old. Mean age at primary repair was 14.3+/-4.2 years old (range 8-21). Operative technique consisted of performing an ascending-to-abdominal aorta bypass via median sternotomy extended into the epigastrium with a supra-umbilical laparotomy through the mid-line abdominal fascia. Concomitant procedures were performed in six patients: three isolated aortic valve replacements (AVR), two ascending aorta graft replacements and one AVR associated with coronary artery bypass graft (CABG). RESULTS: No postoperative mortality was observed. Mean follow-up time was 10.4+/-9.3 years (range 0.3-27.8). No patients had any graft-related complication or death and all grafts were patent at the end of the follow-up. One patient developed a dilated myocardiopathy, dying at 14 years of follow-up. Four patients had persistence of arterial hypertension controlled with one drug therapy and five patients were asymptomatic. CONCLUSIONS: Ascending-to-abdominal aorta extra-anatomic bypass is a safe, effective and less invasive technique for aortic recoarctation in adults with good results at long-term.
Authors:
Beltran G Levy Praschker; Pierre Mordant; Eleodoro Barreda; Iradj Gandjbakhch; Alain Pavie
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-07-26
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  34     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-17     Completed Date:  2009-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  805-9     Citation Subset:  IM    
Affiliation:
Thoracic and Cardiovascular Surgery Department, University of Paris VI Pierre et Marie, Groupe Hospitalier Pitie-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. beltranlevy@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Surgical / methods
Aorta / surgery*
Aorta, Abdominal / surgery
Aortic Coarctation / surgery*
Blood Vessel Prosthesis Implantation / methods*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Recurrence
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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