title: Surgical management of coarctation of the aorta in adults with concurrent cardiac and aortic disease.
abstract: We evaluated our experience with the surgical management of aortic coarctation (ACo) in adults with concurrent cardiac and aortic disease approached via median sternotomy. Eight patients were presented using a variety of repair techniques including end-to-end anastomosis, transpericardial ascending aorta to descending aorta bypass, and stage 1 elephant trunk insertion. All patients were male and symptomatic at presentation. The average age was 41 years (range, 27-67 years). The systolic blood pressure decreased by a mean of 49 mmHg in the patients presenting with hypertension. The postoperative New York Heart Association functional class was I or II in all patients. Mean length of stay was 7.7 days. There were no perioperative complications, and overall survival was 100%. Operative repair of complex ACo can be safely accomplished through the mediastinum in patients in whom a conventional left thoracotomy may not be the preferred approach.
authors.affiliation: Texas Children's Hospital, Houston, TX 77030, USA. rxbryan1@texaschildrenshospital.org
authors.forename: Roosevelt
authors.initials: R
authors.lastname: Bryant
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Gonzalez-Stawinski
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
authors.forename: Lars G
authors.initials: LG
authors.lastname: Svensson
mesh_terms: D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery; D001017:Aortic Coarctation / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000601:surgery*; D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014656:Vascular Surgical Procedures / Q000379:methods*