Reconstruction of the supra-aortic trunks.
OBJECTIVE
To review our 10-year experience of reconstruction of the supra-aortic trunks.


METHODS
Retrospective study.


METHODS
Teaching hospital, The Netherlands.


METHODS
47 patients who required reconstruction of the supra-aortic trunks for stenotic or occlusive disease between April 1987 and May 1997.


METHODS
Right-sided bifurcation graft through a sternotomy (n = 25), left-sided thoracotomy (n = 1), and extra-anatomic bypass (n = 21).


METHODS
Morbidity, mortality, and long term patency.


RESULTS
3 patients died (6%); 7 (15%) developed major complications (leak from the brachiocephalic stump, n = 2, and acute occlusion of the bypass graft, n = 5) all of which were successfully treated by immediate reoperation; and 9 (19%) developed minor complications, all of which resolved within 3 months. The median follow up was 36 months (range 1-108), and the 3-year patency rate was 80%. No patient died during the follow up period, but a further 3 were lost to follow up. The remaining 41 were all assessed by duplex scanning or angiography, and 3 required further operation for recurrent symptoms; 33 remained completely free of symptoms.


CONCLUSIONS
Symptomatic stenotic or occlusive lesions of the supra-aortic trunks can be treated with acceptable morbidity and mortality, giving long term benefit to patients.
Taha
A A
AA
Department of Vascular Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Vahl
A C
AC
de Jong
S C
SC
Vermeulen
E G
EG
van der Waal
K
K
Leydekkers
V J
VJ
Rauwerda
J A
JA
D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk / Q000601:surgery*; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery*; D013997:Time Factors; D014654:Vascular Patency