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Ann Thorac Surg 1977;23:442-448
© 1977 The Society of Thoracic Surgeons

Articles

Ascending Aorta-Abdominal Aorta Bypass: Indications, Technique, and Report of 12 Patients

Don C. Wukasch, M.D.*, Denton A. Cooley, M.D., Frank M. Sandiford, M.D., Gianantonio Nappi, M.D., George J. Reul, Jr., M.D.

Division of Surgery, Texas Heart Institute of St Luke's Episcopal and Texas Children's Hospitals, and the Department of Surgery, University of Texas Medical School, Houston, TX.

* Address reprint requests to Dr. Wukasch, Texas Heart Institute, PO Box 20345, Houston, TX 77025.

Use of the supraceliac segment of the abdominal aorta for ascending aorta-abdominal aorta bypass (AAAAB) offers a new technique for management of certain difficult surgical problems. Since 1973, we have performed AAAAB in 12 patients: 4 with recurrent coarctation of the thoracic aorta; 4 with coarctation of the thoracic aorta and associated cardiac lesions requiring a concomitant intracardiac procedure; 2 with recurrent aortoiliac occlusive disease (AIOD); 1 with interruption of the aortic arch requiring concomitant pulmonary artery banding; and 1 with coarctation of the abdominal aorta. In 3 of these patients (2 with recurrent AIOD and 1 with coarctation of the abdominal aorta) the distal anastomosis was made to the distal abdominal aorta or femoral arteries. Ten patients (83.3%) experienced satisfactory results; 2 patients (16.6%) died. The technique of AAAAB provides a practical solution to complex situations in which previous procedures preclude a standard operative approach, or when necessary concomitant procedures would otherwise require a two-stage operation.




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