title: Reconstruction of the supra-aortic trunks.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: A A
authors.initials: AA
authors.lastname: Taha
authors.forename: A C
authors.initials: AC
authors.lastname: Vahl
authors.forename: S C
authors.initials: SC
authors.lastname: de Jong
authors.forename: E G
authors.initials: EG
authors.lastname: Vermeulen
authors.forename: K
authors.initials: K
authors.lastname: van der Waal
authors.forename: V J
authors.initials: VJ
authors.lastname: Leydekkers
authors.forename: J A
authors.initials: JA
authors.lastname: Rauwerda
mesh_terms: 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