[Open reconstruction of the descending aorta from sternotomy in combined pathology of the thoracic aorta and heart].

Objective: To present our experience of single-stage repair of descending thoracic aorta (DTA) with concomitant pathology of heart and/or proximal thoracic aorta.

Material and methods: We conducted a retrospective medical chart review of all patients who performed thoracic aortic repair and/or cardiac operations with concomitant descending thoracic aorta repair through median sternotomy in our center between 2016 and April 2021. Descending thoracic aorta pathologies were presented coarctation, false aneurysm, and extensive thoracic aortic aneurysm. In coarctation cases, we performed open anatomical repair or extranatomic ascending-to-descending bypass depending on the technical feasibility. Importantly, in extensive aneurysm cases, distal anastomosis was performed using horizontal mattress sutures with Teflon pledgettes that tied outside the aortic wall in circulatory arrest due to technical complexity. We analyzed surgical technique, early results and complication.

Results: We included 14 patients according to inclusion criteria. There was no hospital mortality. Median cardiopulmonary bypass time was149.71±54.3 min, aortic cross clamp time - 86.14±37.46 min, 'skin-to-skin' operation time - 340.8±91.49 min, circulatory arrest - 48.25±25.93 min, blood loss - 971±319 ml. Hospital stay was 11±3 days (8-17 days), ICU stay - 1.5±0.8 days (1-3 days).

Conclusion: Single-stage thoracic aortic replacement with concomitant descending thoracic aorta repair through median sternotomy had satisfactory results.