[Extra-anatomic thoracic aortic bypass operations].
OBJECTIVE
When the patient condition contraindicates major surgery for descending thoracic aneurysms, the surgeon should consider using an ascending aorta to abdominal aorta bypass graft, leaving the diseased segment undisturbed. Our experience with eight patients is presented.


METHODS
Between 1988 and 2008, eight patients were treated for the following indications: reoperation for coarctation (two patients), complicated descending aortic aneurysms (five patients), and posttraumatic descending aorta dissection (one patient). The mean age of the patients was 44+/-8 years (range, 27-53 years). There were 6 (75%) males and 2 (25%) females. Emergency operations were performed in three patients (two with aortic recoarctation, one with posttraumatic aortic dissection). Two cases were reoperations (both after recoarctation). Descending aorta was ligated in seven cases. Distal anastomosis was connected with abdominal aorta in four cases and with iliac arteries in four patients.


RESULTS
Three early deaths occurred. Two patients died after emergency operation after recoarctation and posttraumatic aortic dissection, and one patient died after descending aorta aneurysm correction because of bleeding.


CONCLUSIONS
In complex aortic coarctation, extra-anatomic bypass operation remains an effective procedure. The usage of these procedures in patients with descending aortic aneurysms remains complicated.
Heart Surgery Center, Vilnius University, Lithuania. arunas.valaika@santa.lt
Arūnas
A
Valaika
Gediminas
G
Norkūnas
Gintaras
G
Kalinauskas
Giedre
G
Nogiene
Jurgis
J
Veriznikovas
Giedrius
G
Uzdavinys
Vytautas
V
Sirvydis
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome