title: New technique for single-staged repair of aortic coarctation and coexisting cardiac disorder.
abstract: The management of adults with aortic coarctation and a coexisting cardiac disorder is still a surgical challenge. Single-staged procedures have lower postoperative morbidity and mortality rates than do 2-staged procedures. We present our experience with arch-to-descending aorta bypass grafting in combination with intracardiac or ascending aortic aneurysm repair.From October 2004 through April 2010, 5 patients (4 men, 1 woman; mean age, 45.8 ± 9.4 yr) underwent anatomic bypass grafting of the arch to the descending aorta through a median sternotomy and concomitant repair of an intracardiac disorder or an ascending aortic aneurysm. Operative indications included coarctation of the aorta in all cases, together with severe mitral insufficiency arising from damaged chordae tendineae in 2 patients, ascending aortic aneurysm with aortic regurgitation in 2 patients, and coronary artery disease in 1 patient. Data from early and midterm follow-up were reviewed.There was no early or late death. Follow-up was complete for all patients, and the mean follow-up period was 34.8 ± 18 months (range, 18 mo-5 yr). All grafts were patent. No late graft-related sequelae or reoperations were observed.For single-staged repair of aortic coarctation with a coexistent cardiac disorder, we propose arch-to-descending aorta bypass through a median sternotomy as an alternative for selected patients.
authors.affiliation: Department of Cardiovascular Surgery, Sema Hospital, Istanbul, Turkey. aakorkmaz@gmail.com
authors.forename: Askin Ali
authors.initials: AA
authors.lastname: Korkmaz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Guden
authors.forename: Burak
authors.initials: B
authors.lastname: Onan
authors.forename: Sevim Indelen
authors.initials: SI
authors.lastname: Tarakci
authors.forename: Ali Soner
authors.initials: AS
authors.lastname: Demir
authors.forename: Ertan
authors.initials: E
authors.lastname: Sagbas
authors.forename: Tugay
authors.initials: T
authors.lastname: Sarikaya
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D056346:Sternotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects