Coarctations of descending and abdominal aorta: long-term results of surgical therapy.
OBJECTIVE
Nonarteriosclerotic and nonarteritic descending and abdominal aortic coarctation (DAAC) is a rare disease with a great variety of morphologic findings. The additional affliction of renal and other splanchnic arteries often affords complex corrective procedures. We report on our single-center long-term experiences with operative treatment of this malformation.


METHODS
Over a period of 21 years, 15 patients (10 female and 5 male patients; age range, 8 to 57 years) were operated on for DAAC. Six patients had additional stenoses of eight renal arteries, and three had splanchnic arterial obstructions. At 4 to 25 years after the operation, all surviving patients underwent a clinical and a spiral computed tomography examination.


RESULTS
There was one intraoperative death due to exsanguination after the rupture of a poststenotic aneurysm of the infrarenal aorta. Fourteen patients were discharged free of symptoms. During follow-up, four repeated operations were necessary for renal arterial bypass stenoses or aneurysms. One late death occurred as the result of an unrelated disease.


CONCLUSIONS
Complete operative correction of DAAC usually can be accomplished as a single-stage procedure with low morbidity and mortality rates. The reconstruction of all renal arteries is essential to cure hypertension. Consequent follow-up is recommended for detection of late postoperative complications.
Department of Thoracic and Vascular Surgery, University of Ulm, Germany.
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Fleiter
D000293:Adolescent; D000328:Adult; D001012:Aorta, Abdominal / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography; D002423:Cause of Death; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015996:Survival Rate; D014057:Tomography, X-Ray Computed