Surgical management of middle aortic syndrome in an adult

Luu, Hubert Y.; Pulcrano, Marisa E.; Hua, Hong

doi:10.1016/j.jvscit.2019.10.008

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Recently, endoscopic surgery with a small incision 14 and revascularization using the new four-branch Dacron graft have been reported, and good long-term results are expected; however, careful follow-up after surgery is required. 15,16 The thickened intima and adventitia of patients with TA can cause arterial dissection and anastomotic pseudoaneurysm. Destruction of the media's elastic component occurs before adventitial fibrosis can weaken the vessel wall and cause complications.…”

Section: Discussionmentioning

confidence: 99%

Surgical 5-year Outcomes of Extra-Anatomical Bypass for Middle Aortic Syndrome: A Case Series

Yamamoto

Endo

Shimada

et al. 2021

Vasc Endovascular Surg

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Background Middle aortic syndrome is a rare disease. Several surgical treatments are available; however, the optimal treatment strategy and long-term outcomes remain unelucidated. We herein report the 5-year outcomes of six patients treated with extra-anatomical bypass surgery for middle aortic syndrome. Case presentations Between 2013 and 2016, six patients underwent extra-anatomical bypass for middle aortic syndrome at our institute: three had Takayasu’s arteritis, one had vessel vasculitis, and two had middle aortic hypoplastic syndrome of unknown origin. The patients included five women and one man, with a mean age of 59.7 years. Four patients had uncontrolled hypertension and were receiving antihypertensive medications. The mean ankle–brachial pressure index was .61. The three patients with Takayasu’s arteritis were hospitalized for congestive heart failure. These patients underwent bypass surgery from the descending aorta to the infrarenal abdominal aorta, and one also underwent concomitant heart surgery. The patient with microscopic polyangiitis underwent Y-grafting with an aortic aneurysmectomy. Subsequently, bypass surgery was performed from the descending aorta to the graft via the diaphragm. The two patients with unknown causes underwent bypass surgery from the proximal descending aorta to the distal descending thoracic aorta. There were no early or late deaths at the 5-year follow-up. We did not observe any changes in anastomotic site stenosis or new aneurysmal changes during the follow-up period. The number of antihypertensive medications was reduced in all cases, and critical symptoms, including headache, severe abdominal pain, claudication, and heart failure, improved in all patients. The ankle–brachial pressure index increased to 1.11 and did not change for five years. Renal function remained stable, and the brain natriuretic peptide level decreased from 302.8 to 74.5 pg/mL at follow-up. Conclusion Extra-anatomical bypass for middle aortic syndrome is safe and effective, and can help prevent renal failure, and relieve critical ischemic symptoms.

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Section: Discussionmentioning

confidence: 99%

Surgical 5-year Outcomes of Extra-Anatomical Bypass for Middle Aortic Syndrome: A Case Series

Yamamoto

Endo

Shimada

et al. 2021

Vasc Endovascular Surg

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“…If symptoms did persist, the patient could potentially require endovascular repair of the abdominal aorta given that it was not repaired during this procedure. 5…”

Section: Case Presentationmentioning

confidence: 99%

Anesthetic Management of Middle Aortic Syndrome in an Adult: A Case Report

Senozan,

Clarke,

Abraham

et al. 2024

A&A Practice

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Middle aortic syndrome (MAS) is a rare disorder characterized by narrowing of the aorta. Depending on the location and extent of aortic narrowing, surgical management may be necessary to prevent long-term sequelae, such as stroke and congestive heart failure. We report a case of MAS and discuss the unique intraoperative anesthetic considerations including hemodynamic monitoring proximal and distal to the aortic narrowing, minimizing the risk of spinal cord ischemia, and utilization of intraoperative dobutamine stress testing to guide surgical management.

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Mid-aortic syndrome presenting in adulthood: A case report and review of the literature

Whipple,

Craswell

2024

Journal of Vascular Nursing

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Surgical management of middle aortic syndrome in an adult

Cited by 4 publications

References 7 publications

Surgical 5-year Outcomes of Extra-Anatomical Bypass for Middle Aortic Syndrome: A Case Series

Surgical 5-year Outcomes of Extra-Anatomical Bypass for Middle Aortic Syndrome: A Case Series

Anesthetic Management of Middle Aortic Syndrome in an Adult: A Case Report

Mid-aortic syndrome presenting in adulthood: A case report and review of the literature

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