title: Hypothermic circulatory arrest for the surgical treatment of complicated adult coarctation of the aorta.
abstract: OBJECTIVE
  This study was designed to evaluate the surgical treatment of recurrent coarctation by a new technique.
  
  
  BACKGROUND
  Recurrent coarctation either from aneurysm or recurrent constriction is a difficult problem in the adult because of the possible interruption of important collateral circulation.
  
  
  METHODS
  We reviewed four patients who underwent recurrent coarctation surgery with the use of deep hypothermic circulatory arrest (HCA).
  
  
  RESULTS
  All four patients survived. Deep HCA facilitated precise surgical resection and there was no postoperative paraplegia, stroke, or myocardial infarction.
  
  
  CONCLUSIONS
  Deep HCA and resection and grafting of the coarctation is indicated for complicated adult coarctations, particularly when the collateral circulation is in doubt.
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: Tomas
authors.initials: T
authors.lastname: Gudbjartsson
authors.forename: Manu
authors.initials: M
authors.lastname: Mathur
authors.forename: Tomislav
authors.initials: T
authors.lastname: Mihaljevic
authors.forename: Lishan
authors.initials: L
authors.lastname: Aklog
authors.forename: John G
authors.initials: JG
authors.lastname: Byrne
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Cohn
mesh_terms: D000328:Adult; D000368:Aged; D001017:Aortic Coarctation / Q000175:diagnosis* / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018570:Risk Assessment; D016896:Treatment Outcome