Intermediate-term results of ascending-descending posterior pericardial bypass of complex aortic coarctation.
OBJECTIVE
Extra-anatomic bypass of complex thoracic aortic disease through a median sternotomy has been reported as a safe alternative to thoracotomy. Our objective was to examine intermediate-term outcomes.


METHODS
We retrospectively reviewed 50 consecutive patients with congenital aortic coarctation or recurrent coarctation who underwent ascending-descending posterior pericardial aortic bypass between January 1985 and November 2005. Demographic data, in-hospital and postoperative morbidity and mortality, and resolution of hypertension were determined by examination of the medical record.


RESULTS
The mean age at operation was 42 years; 27 (54%) were men. There were no perioperative deaths. Upper-extremity blood pressure after coarctation repair with ascending-descending aortic bypass was significantly improved. Mean systolic blood pressure decreased from 158 +/- 25 mm Hg preoperatively to 123 +/- 14 mm Hg postoperatively (P < .001). There were no graft-related deaths or complications in follow-up extending up to 20 years.


CONCLUSIONS
The ascending-descending aortic bypass through a posterior pericardial approach is a safe operation and is effective in relieving obstruction and improving hypertension.
McKellar
Stephen H
SH
Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Schaff
Hartzell V
HV
Dearani
Joseph A
JA
Daly
Richard C
RC
Mullany
Charles J
CJ
Orszulak
Thomas A
TA
Sundt
Thoralf M
TM
Connolly
Heidi M
HM
Warnes
Carole A
CA
Puga
Francisco J
FJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D001027:Aortography; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery; D016896:Treatment Outcome