title: Aortic valvular insufficiency and postductal aortic coarctation with small aorta syndrome: one-stage surgical management using extra anatomic bypass through median sternotomy.
abstract: A 30-year-old man who had undergone repair for coarctation of the thoracic aorta at age 7 and mitral valve annuloplasty at age 9 was admitted for shortness of breath and claudication of both lower legs. The pre-operative angiogram showed severe aortic regurgitation, moderate coarctation of the thoracic aorta beyond the left subclavian artery, a degree of hypoplasia of the infrarenal abdominal aorta, and total occlusion of both external iliac arteries. Aortic valve replacement, ascending-to-bilateral femoral arterial bypass, and end expanded polytetra fluoro ethylene (ePTFE) graft-to-descending aorta bypass was performed via a median sternotomy. Ascending-to-descending aortic bypass via the posterior pericardium allows simultaneous intracardiac repair or an alternative approach for the patient with complex coarctation.
authors.affiliation: Department of Thoracic Surgery, Anjo Kosei Hospital, Anjo, Aichi, Japan. mizumoto@hsp.shingu.wakayama.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Mizumoto
authors.forename: Toshiya
authors.initials: T
authors.lastname: Tokui
authors.forename: Takane
authors.initials: T
authors.lastname: Hiraiwa
authors.forename: Tosihiko
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D001017:Aortic Coarctation / Q000473:pathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005263:Femoral Artery / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D013249:Sternum / Q000601:surgery*; D013577:Syndrome
chemical_list: D011138:Polytetrafluoroethylene