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Adolescent coarctation of aorta treated with subclavian-descending aorta bypass grafting

Published online by Cambridge University Press:  27 November 2014

Skander Benomrane ,
Khedija Soumer  and
Adel Khayati
Skander Benomrane
Affiliation:
Department of Cardiothoracic and Vascular Surgery, La Rabta Hospital, Tunis, Tunisia College of Medicine, University of Tunis El Manar, Tunis, Tunisia
Khedija Soumer*
Affiliation:
Department of Cardiothoracic and Vascular Surgery, La Rabta Hospital, Tunis, Tunisia College of Medicine, University of Tunis El Manar, Tunis, Tunisia
Adel Khayati
Affiliation:
Department of Cardiothoracic and Vascular Surgery, La Rabta Hospital, Tunis, Tunisia College of Medicine, University of Tunis El Manar, Tunis, Tunisia
*
Correspondence to: K. Soumer, No. 8, Ahmed El Mahdaoui Street, Borj Louzir, Ariana, Tunis 2073, Tunisia. Tel: +216 71 571 237; Fax: +216 71 571 237; E-mail: soumerkhedija@yahoo.fr
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Abstract

Background

Aortic coarctation in older children most frequently represents cases of re-coarctation following previous transcatheter or surgical therapy or missed cases of native coarctation.

Methods

We describe three cases of adolescents – two girls and one boy – with aortic coarctation, operated between January, 2012 and December, 2013. Computed tomography angiography was performed as an essential diagnostic procedure.

Results

Hypertension was detected, and weaker arterial pulses in the lower limbs were noted in all cases. All operations were performed via left posterolateral thoracotomy. Aortic coarctation was treated surgically, with left subclavian-lower descending thoracic aorta bypass grafting. Postoperative course was uneventful in all cases. No residual brachial-ankle pressure gradient was observed, and all patients have remained in good condition after the operation.

Conclusions

Surgical treatment of aortic coarctation in adolescent patients can be achieved by resection with end-to-end anastomosis, interposition of a graft or bypass graft across the area of coarctation when the distance to be bridged is too long for end-to-end repair.

The extra-anatomic subclavian-descending aortic bypass grafting provides good results in adolescent patients, particularly in those with complex coarctation.

Keywords

Adultaortacoarctationsurgery
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 7 , October 2015 , pp. 1290 - 1292
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Copyright
© Cambridge University Press 2014 

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References

1. Alejandro, A, Teresa, SM, Pere, F, Miguel Torner, S. Repair of aortic coarctation in patients more than 50 years of age. Ann Thorac Surg 1999; 67: 1376–1379.Google Scholar
2. Anagnaostopoulos–Tzifa, A. Management of aortic coarctation in adults: endovascular versus surgical therapy. Hellenic J Cardiol 2007; 48: 290–295.Google Scholar
3. Manganas, C, Iliopoulos, J, Chard, RB, Nunn, GR. Reoperation and coarctation of the aorta: the need for, lifelong surveillance. Ann Thorac Surg 2001; 72: 1222–1224.CrossRefGoogle ScholarPubMed
4. Vijayanagar, R, Natarajan, P, Eckstein, PF, Bognolo, DA, Toole, JC. Aortic valvular insufficiency and postductal aortic coarctation in the adult. Combined surgical management through median sternotomy: a new surgical approach. J Thorac Cardiovasc Surg 1980; 79: 266–268.CrossRefGoogle ScholarPubMed
5. Elkerdany, A, Hassouna, A, Elsayegh, T, Azab, S, Bassiouni, M. Left subclavian-aortic bypass grafting in primary isolated adult coarctation. Cardiovasc Surg 1999; 7: 351–354.Google Scholar
6. Koller, M, Rothlin, M, Senning, A. Coarctation of the aorta: review of 362 operated patients. Long-term follow-up and assessment of prognostic variables. Eur Heart J 1987; 8: 670–679.Google Scholar
7. Izhar, U, Schaff, HV, Mullany, CJ, Daly, RC, Orszulak, TA. Posterior pericardial approach for ascending aorta-to-descending aorta bypass through a median sternotomy. Ann Thorac Surg 2000; 70: 31–37.Google Scholar
8. Arakelyan, V, Spiridonov, A, Bockeria, L. Ascending-to-descending aortic bypass via right thoracotomy for complex (re-) coarctation and hypoplastic aortic arch. Eur J Cardiothorac Surg 2005; 27: 815–820.Google Scholar