title: [Extra-anatomic bypass for complex aortic coarctation in adults].
abstract: OBJECTIVE
  To demonstrate an effective operation of extra-anatomic bypass for complex aortic coarctation in adults.
  
  
  METHODS
  Between July 1997 and October 2010, 51 patients underwent extra-anatomic aortic bypass. There were 39 male and 12 female patients. Mean age was (40 ± 14) years (ranging from 18 to 63 years). Operative technique of extra-anatomic bypass consisted of performing an ascending-to-descending or abdominal or femoral aorta bypass (8, 39 and 4 patients). Concomitant procedures were performed in 38 patients: 10 isolated aortic valve replacements (AVR), 11 aortic root replacements (Bentall), 4 ascending aorta replacements including 3 concomitant AVR, 5 mitral valve replacements including 3 concomitant AVR, 4 ventricular septal defect correcting with AVR, and 4 coronary artery bypass graft.
  
  
  RESULTS
  Mean follow-up time was (30 ± 9) months (ranging from 5 to 60 months). Two patients were reoperated for hemorrhage in descending aorta anastomosis, one of whom was dead of multiple organ failure in perioperative period. Upper-extremity blood pressure after coarctation correction with extra-anatomic aortic bypass was significantly improved (< 10 mmHg, 1 mmHg = 0.133 kPa). Arterial hypertension was well improved, except 10 patients controlled with less drug therapy. All grafts were patent without obstruction or pseudoaneurysm formation in the follow-up period evaluated by vascular ultrasound and computed tomographic angiogram.
  
  
  CONCLUSIONS
  Extra-anatomic aortic bypass is a safe and effective option for complex aortic coarctation in adults.
authors.affiliation: Department of Cardiovascular Surgery, Beijing Anzhen Hospital of Capital University of Medical Sciences, Beijing 100029, China.
authors.forename: Xu-dong
authors.initials: XD
authors.lastname: Pan
authors.forename: Si-hong
authors.initials: SH
authors.lastname: Zheng
authors.forename: Yi-peng
authors.initials: YP
authors.lastname: Ge
authors.forename: Jin-rong
authors.initials: JR
authors.lastname: Xue
authors.forename: Jun-ming
authors.initials: JM
authors.lastname: Zhu
authors.forename: Yong-min
authors.initials: YM
authors.lastname: Liu
authors.forename: Li-zhong
authors.initials: LZ
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000601:surgery; D001017:Aortic Coarctation / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult