title: Single Stage Repair for Aortic Coarctation associated with Intracardiac Defects Using Extra-Anatomic Bypass Graft in Adults.
abstract: OBJECTIVE
  Coarctation of the aorta in adulthood is generally associated with other cardiovascular disorders requiring surgical management. An extra anatomic bypass grafting from the ascending to descending aorta by posterior pericardial approach via median sternotomy could be a reasonable single stage surgical strategy for these patients.
  
  
  METHODS
  Seven male patients aged between 14-41 years underwent an extra anatomic bypass grafting for coarctation repair concomitantly with the surgical management of the associated cardiovascular disorders via median sternotomy. Preoperative mean systolic arterial blood pressure was 161.8±24.5 mmHg, although the patients were under treatment of different combinations of antihypertensive agents. Additional surgical procedures were: aortic valve replacement (n=4), ventricular septal defect (VSD) closure (n=2), ascending aortic replacement (n=3) and Bentall procedure (n=1). None of our patients have been previously diagnosed or operated on for coarctation. Data were evaluated during their hospital stay and in post-operative follow-up.
  
  
  RESULTS
  The post-operative course was uneventful in all but one patient was re-operated on due to bleeding. There was neither mortality nor significant morbidity during the in-hospital period and all patients were discharged within 5-9 (mean: 6.3±1.5) days. The mean follow up period was 71.83±23 months (range: 23-95 months). Unfortunately one of our patients could not be contacted for a follow up period because of invalid personal data.
  
  
  CONCLUSIONS
  Coarctation of the aorta in adulthood associated with other cardiovascular disorders can be operated on simultaneously via an extra anatomic bypass grafting technique with low morbidity and mortality.
authors.affiliation: Department of Cardiovascular Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Duvan
authors.affiliation: Department of Cardiovascular Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Mehmet Sanser
authors.initials: MS
authors.lastname: Ates
authors.affiliation: Department of Cardiovascular Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Burak Emre
authors.initials: BE
authors.lastname: Onuk
authors.affiliation: Department of Cardiovascular Anaesthesiology, Guven Hospital, Ankara, Turkey.
authors.forename: Beyhan
authors.initials: B
authors.lastname: Bakkaloglu
authors.affiliation: Department of Cardiovascular Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Umit Pinar
authors.initials: UP
authors.lastname: Sungur
authors.affiliation: Department of Cardiovascular Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kurtoglu
authors.affiliation: Department of Cardiovascular Surgery, Guven Hospital, Ankara, Turkey.
authors.forename: Yahya Halidun
authors.initials: YH
authors.lastname: Karagoz
keywords: Aortic coarctation; Associated disease; Bypass, graft; Median sternotomy