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

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

doi:10.1016/s0003-4975(10)64164-1

Cited by 73 publications

(39 citation statements)

References 4 publications

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“…In this series there were no postoperative deaths. Although the present work presents a small number of patients, its mortality and morbidity rates compares favorably [11,12,14].…”

Section: Discussionmentioning

confidence: 93%

“…There are various reports with extra-anatomical aortic bypass for recurrent aortic coarctation. Most of these reported series require institution of CPB or re-entering the left chest [11][12][13][14][15][16]. In the Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Mean age at primary www.elsevier.com/locate/ejcts European Journal of Cardio-thoracic Surgery 34 (2008) 805-809 repair was 14.3 AE 4.2 years old (range[8][9][10][11][12][13][14][15][16][17][18][19][20][21]. All patients presented arterial hypertension.…”

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confidence: 99%

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Long-term results of ascending aorta-abdominal aorta extra-anatomic bypass for recoarctation in adults with 27-year follow-up

Praschker

Mordant

Barreda

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Objective: The surgical treatment of recurrent coarctation in adults supposes a redo left thoracotomy with adhesions and high risk of bleeding and injury of adjacent nerves. The rate of paraplegia in these cases may reach 2.6%. Extra-anatomic aortic bypass avoids these complications. We present our results with ascending-to-abdominal aorta extra-anatomic bypass for recurrent aortic coarctation in adults. Methods: Between September 1979 and November 2006 12 patients underwent ascending-to-abdominal aorta bypass. There were 10 males and 2 females. Mean age was 36.2 AE 11.3 (range 21-57) years old. Mean age at primary repair was 14.3 AE 4.2 years old (range 8-21). Operative technique consisted of performing an ascending-to-abdominal aorta bypass via median sternotomy extended into the epigastrium with a supra-umbilical laparotomy through the mid-line abdominal fascia. Concomitant procedures were performed in six patients: three isolated aortic valve replacements (AVR), two ascending aorta graft replacements and one AVR associated with coronary artery bypass graft (CABG). Results: No postoperative mortality was observed. Mean follow-up time was 10.4 AE 9.3 years (range 0.3-27.8). No patients had any graft-related complication or death and all grafts were patent at the end of the follow-up. One patient developed a dilated myocardiopathy, dying at 14 years of follow-up. Four patients had persistence of arterial hypertension controlled with one drug therapy and five patients were asymptomatic. Conclusions: Ascending-toabdominal aorta extra-anatomic bypass is a safe, effective and less invasive technique for aortic recoarctation in adults with good results at longterm. #

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“…In this series there were no postoperative deaths. Although the present work presents a small number of patients, its mortality and morbidity rates compares favorably [11,12,14].…”

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term results of ascending aorta-abdominal aorta extra-anatomic bypass for recoarctation in adults with 27-year follow-up

Praschker

Mordant

Barreda

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…We did an extra anatomical bypass from ascending aorta to supraceliac artery to relive his symptoms. In 1977 Wukasch and colleagues [4] reported extra-anatomical bypass from ascending aorta to supraceliac bare portion of abdominal aorta. Advantage of this procedure is that the supraceliac bare area has less tributaries and least likely to be atherosclerotic thus less likely of bleeding, requires shortest course of graft, less bowl manipulation so less intestinal complication [5].…”

Section: Discussionmentioning

confidence: 99%

Malposition of Stent a Rare Complication in Coarctation of Aorta Corrected with Extraanatomic Aortic Bypass

Kisku¹,

Pramanik²,

Aditya³

et al. 2017

WJCS

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Mal-position of stent in coarctation of aorta is very rare but a major complication. Symptoms can worsen even more. We present here one such case where stenting done in some other institute in which we did an extra-anatomical bypass from ascending aorta to supracelial aorta successfully bypassing the coarct segment. This was an early approach without assistance of Cadiopulmonary (CP) Bypass. We conclude that this procedure should be done in centres where experienced operator and cardiac surgery back up is present. This was a good approach without assistance of CP Bypass.

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“…Extra anatomical bypass with proximal anastomosis from ascending aorta and distal anastomosis to the descending aorta and even to the abdominal aorta have been described for complex coarctation [6][7][8]. In 1975, Edie et al described extra anatomical bypass from ascending aorta to descending aorta for complex coarctation using combined sternotomy and left thoracotomy [6].…”

Section: Discussionmentioning

confidence: 99%

Extra anatomical bypass for complex coarctation of aorta in an adult—a case report

Raju

Muthubaskaran

Muralidharan

et al. 2011

Indian J Thorac Cardiovasc Surg

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The surgical management of complex coarctation in an adult remains a challenge till date. Various surgical options are available in treating complex coarctation in adult including anatomical and extra anatomical corrections. Percutaneous intervention has very limited role, and an option is still uncertain. We are reporting a 28 year old male with complex coarctation of aorta who underwent an Extra Anatomocal Bypass using 22 mm Dacron graft from ascending aorta to descending aorta through midline sternotomy using posterior pericardial approach. He had uneventful postoperative period with acceptable gradients between both limbs. He remains asymptomatic on one year follow up with reduced need of antihypertensive medication.Twenty-eight year old male, a known hypertensive for 4 years on irregular medication presented with history of New York Heart Association (NYHA) Class II dyspnoea of 2 year duration. He also had giddiness on exertion, Claudication pain over the both lower limb (Claudication distance was 200 m) and numbness over the left upper limb of 2 months duration. On examination, he was well built with pulse rate of 76/min. Both lower limb pulses including both femoral pulses were absent. Left Brachial and radial pulses were feeble. Right upper limb and bilateral carotid artery pulses were well felt. His blood pressure on the right upper limb and left upper limb on supine posture was 160/100 and 110/90 respectively. There was no recordable lower limb blood pressure. A grade 2/6 ejection systolic murmur was heard over the aortic area. Bilateral carotid artery bruit was also heard. His biochemical and haematological investigation were within normal limits. 12 lead electrocardiogram showed left ventricular hypertrophy with strain pattern. Chest roentgenogram (Fig. 1) showed cardiomegaly with cardiothoracic ratio of 65% with mediastinal widening (dilated ascending aorta (28 mm) and left subclavian artery). 2 dimensional Transthoracic Echocardiogram showed complex coarctation of aorta involving the distal arch as well as proximal descending aorta with Peak gradient of 40 mmhg and mean gradient of 20 mmhg. Aortic valve was normal. Computed Aortogram showed complex coarctation of aorta with discrete narrowing in the distal arch between the left common carotid artery and Left subclavian artery with another narrowing between the left subclavian artery and proximal descending aorta with post stenotic dilatation of left subclavian artery and evidence of multiple chest wall collaterals (Fig. 2).He was planned for extra anatomical bypass in view of complexity of disease and technical difficulty as well as morbidity and mortality associated with anatomical approach. Through midline sternotomy, mild hypothermic cardiopulmonary bypass was established by cannulating the ascending aorta and two stage single venous cannula through the right atrium. Left ventricle was vented through right superior pulmonary venous cannula. With heart beating, Starfish suction apparatus (Medtronic, USA) was applied on the left ventricle apex and ...

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

Cited by 73 publications

References 4 publications

Long-term results of ascending aorta-abdominal aorta extra-anatomic bypass for recoarctation in adults with 27-year follow-up

Long-term results of ascending aorta-abdominal aorta extra-anatomic bypass for recoarctation in adults with 27-year follow-up

Malposition of Stent a Rare Complication in Coarctation of Aorta Corrected with Extraanatomic Aortic Bypass

Extra anatomical bypass for complex coarctation of aorta in an adult—a case report

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