Surgical management of middle aortic syndrome in the elderly.
Coarctation of the distal thoracic aorta and/or the abdominal aorta, namely "middle aortic syndrome" (MAS), is a rare congenital cardiovascular defect with the potential for serious ischemic complications. Diagnosis is usually made during childhood or in young adulthood; therefore, the surgical management of MAS in an elderly patient is exceptional. We report the surgical repair of a MAS in a 65-year-old woman with life-threatening renal and mesenteric ischemia. Using the ascending aorta as bypass inflow, a thoracoabdominal bypass with reimplantation of the visceral vessels was performed through sterno-laparotomy with good result. Therapeutic and technical issues are discussed.
Cho
Chika
C
Department of Vascular Surgery, Pitié-Salpétriêre University Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France. cmilleka@yahoo.co.jp
Coscas
Raphael
R
Koskas
Fabien
F
D000368:Aged; D001012:Aorta, Abdominal / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology; D007668:Kidney / Q000098:blood supply; D008643:Mesentery / Q000098:blood supply; D012092:Replantation; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome