Ascending-to-supraceliac abdominal aortic bypass for an adult coarctation of the aorta: a video presentation

U. Chowdhury, Niwin George, L. Sankhyan, Sukhjeet Singh, A. Chauhan, Sreenita Chowdhury
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Abstract

Among the variety of surgical options available for coarctation of the aorta, the resection and/or graft replacement of the diseased aortic segment and anatomical restoration without residual obstruction is the ideal option [1]. However, such a direct approach may be difficult to perform in late presenters with diminished elasticity and/or calcification of the vessels, extensive collateral formation at different anatomic levels, unusual anatomic features or previous operations [2-7]. Use of supraceliac segment of the abdominal aorta for ascending aorta-to-abdominal aorta bypass has been poorly documented in coarctation of the aorta or interrupted aortic arch presenting in adulthood [8-10]. We report a 42-years-old male patient presenting with isolated interrupted aortic arch undergoing ascending aorta-to-supraceliac abdominal aortic bypass without cardiopulmonary bypass. The postoperative recovery was uneventful. We conclude that ascending aorta-to-abdominal aortic bypass in the supraceliac bare area is a versatile technique in late presenters with coarctation of the aorta and eliminates the complications associated with the anatomical repair.
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成人主动脉缩窄的上升至腹腔上腹主动脉搭桥术:视频报告
在多种可用于主动脉缩窄的手术选择中,切除和/或移植物置换病变主动脉段并无残留阻塞的解剖修复是理想的选择。然而,这种直接入路可能难以在晚期患者中实施,因为他们的血管弹性降低和/或钙化,在不同解剖水平上形成广泛的侧支,不寻常的解剖特征或以前的手术[2-7]。在成人中出现的主动脉缩窄或主动脉弓中断的情况下,使用腹主动脉的腹腔上段进行升主动脉至腹主动脉分流术的文献很少[8-10]。我们报告一名42岁男性病患,以孤立性主动脉弓中断为主动脉弓,接受升主动脉至腹腔上主动脉搭桥手术,而非体外循环。术后恢复顺利。我们的结论是,在腹腔上裸区进行升主动脉至腹主动脉旁路手术是一种多用途的技术,可以治疗晚期主动脉狭窄,并消除与解剖修复相关的并发症。
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