Document Detail


Treatment of complex coarctation and coarctation with cardiac lesions using extra-anatomic aortic bypass.
MedLine Citation:
PMID:  20303693     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coarctation of the aorta with cardiac lesions or complex coarctation is a formidable challenge for cardiac surgeons. Extra-anatomic bypass allows simultaneous intracardiac repair or an alternative approach for patients with complex coarctation.
METHODS: Between July 1997 and March 2008, 43 patients with coarctation of the aorta underwent extra-anatomic bypass grafting, including 10 ascending-to-descending aorta bypasses and 33 ascending aorta-to-infrarenal abdominal aorta bypasses. Forty patients had additional cardiovascular disorders and concomitant procedures performed including aortic valve replacement, mitral valve replacement, coronary artery bypass grafting, closure of ventricular septal defect and patent ductus arteriosus, ascending aorta repair, and the Bentall procedure. The other three patients had complex coarctation of the aorta, including a long-segment coarctation in two cases, and descending aortic aneurysm in one.
RESULTS: Two patients died perioperatively: one due to air embolism during the cardiopulmonary bypass; one due to septic shock. There were no late deaths. Complications included laparotomy for mechanical ileus in one and re-exploration for bleeding in one case. There were no strokes or paraplegia and no grafted-related complication during follow-up period. Systolic blood pressure dropped from 160 +/- 27 mm Hg before surgery to 114 +/- 16 mm Hg postoperatively. Only two patients with mild hypertension postoperatively needed oral medicine.
CONCLUSIONS: Extra-anatomic aortic bypass via median sternotomy or median sternotomy-laparotomy can be performed with low morbidity and mortality. It is a preferable single-stage approach for patients with concomitant complex coarctation and cardiovascular disorders.
Authors:
Ren Wang; Li-Zhong Sun; Xiao-Peng Hu; Wei-Guo Ma; Qian Chang; Jun-Ming Zhu; Yong-Min Liu; Cun-Tao Yu
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-19
Journal Detail:
Title:  Journal of vascular surgery     Volume:  51     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-05-12     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1203-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery and Aortic Surgery, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Peking, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aorta, Abdominal / pathology,  radiography,  surgery*
Aortic Aneurysm, Thoracic / diagnosis,  mortality,  surgery*
Aortic Coarctation / diagnosis,  mortality,  surgery*
Blood Vessel Prosthesis Implantation / methods,  mortality
Cardiopulmonary Bypass / methods,  mortality
Cardiovascular Surgical Procedures / methods*
Child
Cohort Studies
Combined Modality Therapy
Female
Follow-Up Studies
Heart Septal Defects, Ventricular / diagnosis,  mortality,  surgery*
Heart Valve Diseases / diagnosis,  mortality,  surgery*
Heart Valve Prosthesis Implantation / methods,  mortality
Humans
Laparotomy / methods
Male
Middle Aged
Retrospective Studies
Risk Assessment
Sternotomy / methods
Survival Analysis
Young Adult

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


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