Document Detail

Off-pump extraanatomic aortic bypass for the treatment of complex aortic coarctation and hypoplastic aortic arch.
MedLine Citation:
PMID:  18222243     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite advances in surgical and interventional techniques, the optimal surgical treatment of severe aortic (re) coarctation and hypoplastic aortic arch is still controversial. Anatomic repair may require extensive dissection, cardiopulmonary bypass, and deep hypothermic circulatory arrest with their inherent risks. The aim of this study was to analyze the outcome of off-pump extraanatomic aortic bypass as a surgical alternative to local repair. METHODS: From February 2000 to December 2005, ten consecutive patients (median age 20 years; range, 11 to 38 years) with severe aortic (re) coarctation (n = 4) and (or) hypoplastic aortic arch (n = 7) underwent off-pump extraanatomic aortic bypass through median sternotomy. All but three patients had undergone previous surgery for coarctation and angioplasty or stenting. Three patients underwent concomitant replacement of the ascending aorta because of an aneurysm using cardiopulmonary bypass. RESULTS: Postoperative hospital course was uneventful in all patients. There was no perioperative mortality or significant morbidity. During a mean follow-up of 48 +/- 22 months no patient required additional procedures. All patients were free of symptoms; no patient showed signs of heart failure after follow-up. At last follow-up, no patient presented with claudication, nor any patient experienced orthostatic problems due to a steal phenomenon. During follow-up, hypertension resolved in all patients with residual mild hypertension in two patients. CONCLUSIONS: Off-pump extraanatomic aortic bypass is an attractive treatment option for complex aortic (re) coarctation and hypoplastic aortic arch. Perioperative risks are minimized, hypertension is influenced favorably, and midterm survival is event-free.
Florian S Schoenhoff; Pascal A Berdat; Mladen Pavlovic; Alexander Kadner; Markus Schwerzmann; Jean-Pierre Pfammatter; Thierry P Carrel
Related Documents :
19561363 - Preoperative 6-minute walk test adds prognostic information to euroscore in patients un...
15172253 - Is a bicuspid aortic valve a risk factor for adverse outcome after an autograft procedure?
22591023 - High uterine contraction rates in births with normal and abnormal umbilical artery gases.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-28     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  460-4     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, University of Berne, Berne, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anastomosis, Surgical
Aortic Arch Syndromes / mortality,  surgery*,  ultrasonography
Aortic Coarctation / mortality,  surgery*,  ultrasonography
Blood Vessel Prosthesis Implantation*
Cardiopulmonary Bypass / methods
Cardiovascular Surgical Procedures / methods*
Cohort Studies
Echocardiography, Doppler
Follow-Up Studies
Heart Defects, Congenital / mortality,  surgery,  ultrasonography
Magnetic Resonance Angiography
Postoperative Care
Retrospective Studies
Risk Assessment
Survival Analysis
Treatment Outcome
Comment In:
Ann Thorac Surg. 2008 Feb;85(2):464   [PMID:  18222244 ]

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

Previous Document:  Retrograde hot-shot cardioplegia in patients with left ventricular hypertrophy undergoing aortic val...
Next Document:  Antegrade cerebral perfusion for acute type A aortic dissection in 120 consecutive patients.