title: Interruption of aortic arch in adults: surgical experience with extra-anatomic bypass.
abstract: We reviewed our 3-year experience in treating interruption of the aorta in adult patients. Clinical profiles, surgical management, and results of early and mid-term follow-up are presented. From August 2001 through June 2003, 7 adult patients underwent an extra-anatomic bypass procedure to repair interruption of the aortic arch. Five patients underwent ventral aortic repair through a mid-sternotomy and an upper midline laparotomy, and 2 patients underwent repair through a left posterolateral thoracotomy. A bovine collagen-impregnated polyester fiber graft was used in 6 patients, and a Gore-Tex graft was interposed in 1 patient. All repairs were performed without cardiopulmonary bypass. Follow-up was complete in all patients. The mean follow-up was 1728 +/- 1 months (range, 9-31 months). No neurologic, renal, or gastrointestinal complications were noted in any patient. There was no in-hospital or late mortality or need for re-intervention. All patients were asymptomatic; however, 5 patients had mild residual hypertension. Graft patency in all the patients was confirmed by computed tomographic angiography. Interruption of the aorta is rare in adults. Ventral aortic repair through a midline approach is our preferred technique for surgical repair of this entity, because it avoids the extensive network of collateral vessels on the chest wall, enables simultaneous treatment of associated lesions, and in all likelihood reduces morbidity and mortality.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029, India.
authors.forename: C
authors.initials: C
authors.lastname: Sai Krishna
authors.forename: Anil
authors.initials: A
authors.lastname: Bhan
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sharma
authors.forename: Usha
authors.initials: U
authors.lastname: Kiran
authors.forename: Panangipalli
authors.initials: P
authors.lastname: Venugopal
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D010166:Palliative Care; D013997:Time Factors; D014654:Vascular Patency