Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults.
BACKGROUND
Coarctation represents 5-8% of congenital heart disease. Residual hypertension remains the main problem after late correction. Surgical treatment in the adult remains a challenge for the surgeon. Our prefered method used in this category is the Subclavian-aortic bypass.


METHODS
We have reviewed our registry for the period of 12 years (1998- 2010) and we found a group of 18 adult patients being operated for coarctation of the aorta. The mean age of this group of patients was 24.7 ± 8.43 years (range 16-42 years). 13 were males and 5 females.


RESULTS
Sugical technique: Most of the patients (13 pts, 72%) which were obviously treated with subclavian-aortic bypass with a Dacron prostheses. Mean preoperative and postoperative pressure gradients measured by echocardiography were 77.7 ± 20.16 mmHg and 22.3 ± 9.14 mmHg respectively. No mortality was observed in this series of patients. Chylothorax was the only complication observed in one patient in the early postoperative period.


CONCLUSIONS
Coarctation of the aorta in adults is treated with optimal early results at our surgical centre. Subclavian-aortic bypass grafting requires less aortic dissection, can be performed with a partially occluding clamp, and does not compromise the spinal cord vascularization.
Department of Cardiovascular Surgery, University Hospital Centre "Mother Theresa", Rruga e Dibres, N. 370, Tirana, Albania.
Ali
A
Refatllari
Department of Cardiovascular Surgery, University Hospital Centre "Mother Theresa", Rruga e Dibres, N. 370, Tirana, Albania.
Ermal
E
Likaj
Department of Cardiovascular Surgery, University Hospital Centre "Mother Theresa", Rruga e Dibres, N. 370, Tirana, Albania.
Selman
S
Dumani
adults; bypass graft; coarctation; hypertension; technique