title: Open plugging and extra-anatomical bypass for iatrogenic rupture of coarctation of the aorta.
abstract: We report a successful repair of aortic rupture after balloon angioplasty for re-coarctation using a unique approach and method. A 22-year-old woman underwent emergency surgery for aortic rupture after balloon angioplasty for postoperative aortic re-coarctation. We performed extra-anatomic bypass from the ascending aorta to the descending thoracic aorta through a median sternotomy and incision in the posterior pericardium. The transverse aortic arch was transected, and the distal aortic arch was opened under deep hypothermic circulatory arrest of the lower extremities. The proximal aorta was closed. To seal the aortic rupture site, a tube graft was inserted through the aortotomy and was oversewn with the aorta. Repair of the right ventricular outflow stenosis was concomitantly performed. The patient's postoperative course was uneventful, and she successfully gave birth 2 years postoperatively.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ogasawara
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Daitoku
authors.forename: Satoshi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Ikuo
authors.initials: I
authors.lastname: Fukuda
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D001013:Aorta, Thoracic / Q000293:injuries / Q000601:surgery*; D001017:Aortic Coarctation / Q000628:therapy*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods*; D055815:Young Adult