Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults
DOI:
https://doi.org/10.3889/oamjms.2016.006Keywords:
coarctation, adults, bypass graft, hypertension, techniqueAbstract
BACKGROUND: Coarctation represents 5-8% of congenital heart disease. Residual hypertension remains the main problem after late correction. Surgical treatment in the adult remains a challenge for the surgeon. Our prefered method used in this category is the Subclavian-aortic bypass.
MATERIAL AND METHODS: We have reviewed our registry for the period of 12 years (1998- 2010) and we found a group of 18 adult patients being operated for coarctation of the aorta. The mean age of this group of patients was 24.7 ± 8.43 years (range 16-42 years). 13 were males and 5 females.
RESULTS: Sugical technique: Most of the patients (13 pts, 72%) which were obviously treated with subclavian-aortic bypass with a Dacron prostheses. Mean preoperative and postoperative pressure gradients measured by echocardiography were 77.7 ± 20.16 mmHg and 22.3 ± 9.14 mmHg respectively. No mortality was observed in this series of patients. Chylothorax was the only complication observed in one patient in the early postoperative period.
CONCLUSION: Coarctation of the aorta in adults is treated with optimal early results at our surgical centre. Subclavian-aortic bypass grafting requires less aortic dissection, can be performed with a partially occluding clamp, and does not compromise the spinal cord vascularization.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Waldhausen JA, Myers JL, Campbell DB. Coarctation of the aorta and interrupted aortic arch. In: Baue AE, Geha AS, Hammond GL, Laks H, Naunheim KS. Glenn’s thoracic and cardiovascular surgery. 5th ed. Norwalk, Appleton & Lange, 1991:1107–22.
Crafoord C, Nylin G. Congenital coarctation of the aorta and its surgical treatment. J Thorac Surg. 1945;14:347-3. DOI: https://doi.org/10.1016/S0096-5588(20)31801-8
Campbell M. Natural history of coarctation of the aorta. Br Heart J. 1970;32:633–40.
http://dx.doi.org/10.1136/hrt.32.5.633 DOI: https://doi.org/10.1136/hrt.32.5.633
PMid:5470045 PMCid:PMC487385
Bouchart F, Dubar A, Tabley A, Litzler PY, Haas-Hubscher C, Redonnet M, Bessou JP, Soyer R. Coarctation of the aorta in adults: surgical results and long-term follow-up. Ann Thorac Surg. 2000;70(5):1483-8; discussion 1488-9.
http://dx.doi.org/10.1016/S0003-4975(00)01999-8 DOI: https://doi.org/10.1016/S0003-4975(00)01999-8
Wells WJ, Prendergast TW, Berdjis F, Brandl D, Lange PE, Hetzer R, Starnes VA. Repair of coarctation of the aorta in adults: the fate of systolic hypertension. Ann Thorac Surg. 1996;61(4):1168-71.
http://dx.doi.org/10.1016/0003-4975(96)00008-2 DOI: https://doi.org/10.1016/0003-4975(96)00008-2
Weldon CS, Hartmann AF Jr, Steinhoff NG, Morrissey JD. A simple, safe, and rapid technique for the management of recurrent coarctation of the aorta. Ann Thorac Surg. 1973;15:510-9.
http://dx.doi.org/10.1016/S0003-4975(10)65337-4 DOI: https://doi.org/10.1016/S0003-4975(10)65337-4
Downloads
Published
How to Cite
Issue
Section
License
http://creativecommons.org/licenses/by-nc/4.0