| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;76:1962-1966
© 2003 The Society of Thoracic Surgeons
a Division of Thoracic and Cardiovascular Surgery, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
b Division of Cardiovascular Surgery, Beneficência Portuguesa Hospital of São Paulo, São Paulo, Brazil
Accepted for publication June 13, 2003.
* Address reprint requests to Dr Almeida de Oliveira, R. Barão de Bocaina, 140 Ap. 19o, São Paulo SP 01241-020, Brazil.
e-mail: dcioliveira{at}incor.usp.br
BACKGROUND: We analyzed our 22 years of experience with extraanatomic bypass grafting for repair of aortic arch coarctation in adults. Results from early and midterm follow-up with clinical evaluation and magnetic resonance angiography are reported.
METHODS: Between November 1979 and December 2001, 18 consecutive patients aged 18 to 61 years (mean, 31.8 ± 13.3 years) underwent extraanatomic bypass grafting to repair coarctation of the aortic arch. Six patients (33.3%) had recoarctation after previous repair through a left thoracotomy, and 3 (16.7%) had associated cardiac diseases. The operative technique used in all patients was ascending aorta-to-descending thoracic aorta bypass with a polyethylene terephthalate fiber (Dacron) graft through a median sternotomy and posterior pericardial approach.
RESULTS: Follow-up was completed in all patients, with a mean duration of 5.6 ± 5.7 years (range, 12 months to 22 years). The follow-up interval exceeded 10 years in 5 patients. No neurologic complications, early or late mortality, late reoperations, or graft complications occurred. Six patients (33.3%) had mild hypertension. All patients were asymptomatic with patent Dacron grafts confirmed by echocardiography. Magnetic resonance angiography, performed in 15 (83.3%) patients, revealed that the Dacron grafts were still patent at a mean interval of 4.0 ± 6.2 years (range, 5 days to 22 years) after repair.
CONCLUSIONS: Extraanatomic ascending aorta-to-descending thoracic aorta bypass grafting for repair of aortic arch coarctation in adults is safe, with low morbidity and no mortality. The favorable midterm results indicate this technique is a safe and less invasive means of repairing aortic arch coarctation or recoarctation in adults.
This article has been cited by other articles:
|
|
 |
|
  H. A. Vohra, L. Adamson, and M. P. Haw Does surgical correction of coarctation of the aorta in adults reduce established hypertension? Interactive CardioVascular and Thoracic Surgery, January 1, 2009; 8(1): 123 - 127. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. S. Schoenhoff, P. A. Berdat, M. Pavlovic, A. Kadner, M. Schwerzmann, J.-P. Pfammatter, and T. P. Carrel Off-Pump Extraanatomic Aortic Bypass for the Treatment of Complex Aortic Coarctation and Hypoplastic Aortic Arch Ann. Thorac. Surg., February 1, 2008; 85(2): 460 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Laks, D. Marelli, M. Plunkett, and J. Myers Adult Congenital Heart Disease Card. Surg. Adult, January 1, 2008; 3(2008): 1431 - 1464. [Full Text]
|
|
|
|
 |
|
 A. Aris, M. L. Maestre, and M. T. Subirana Reply to the Editor J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 278 - 278. [Full Text] [PDF]
|
|
|
|
|
|
A. Aris, J. Cobiella, M. L. Maestre, and M. T. Subirana Ascending-descending aortic bypass with the aid of a heart-lifting device. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 433 - 434. [Full Text] [PDF]
|
|
|
|
|
|
V. Agarwal, I. Ramnarine, A. F. Corno, and M. Pozzi Recurrent coarctation in a patient with Alagille syndrome Interactive CardioVascular and Thoracic Surgery, December 1, 2005; 4(6): 514 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Carr, J. J. Amato, and R. S.D. Higgins Long-Term Results of Surgical Coarctectomy in the Adolescent and Young Adult With 18-Year Follow-Up Ann. Thorac. Surg., June 1, 2005; 79(6): 1950 - 1956. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I Ramnarine Role of surgery in the management of the adult patient with coarctation of the aorta Postgrad. Med. J., April 1, 2005; 81(954): 243 - 247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. P. Graham Jr The year in congenital heart disease J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2132 - 2141. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
