Kristofer M Charlton-Ouw1, Maria E Codreanu2, Samuel S Leake3, Harleen K Sandhu3, Daniel Calderon3, Ali Azizzadeh2, Anthony L Estrera2, Hazim J Safi2. 1. Department of Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, Houston, Tex; Memorial Hermann Heart and Vascular Institute, Texas Medical Center, Houston, Tex. Electronic address: kristofer.charltonouw@uth.tmc.edu. 2. Department of Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, Houston, Tex; Memorial Hermann Heart and Vascular Institute, Texas Medical Center, Houston, Tex. 3. Department of Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, Houston, Tex.
Abstract
BACKGROUND: We report on our experience with treatment of adults requiring de novo or redo open aortic coarctation repair mostly by a resection and interposition graft technique. METHODS: We retrospectively reviewed all patients older than 16 years requiring open repair of aortic coarctation. Indications for repair, operative details, and outcomes were analyzed. RESULTS: Between 1996 and 2011, we treated 29 adult aortic coarctation patients with open repair. The mean age was 42 years (range, 17-69 years), and there were 15 men. Nine patients had previous repair with recurrence; the remaining 20 had native coarctation. Thoracic aortic aneurysms were present in 22 patients (76%), ranging in size from 3.0 to 9.6 cm (mean, 4.8 cm). Four patients had intercostal artery aneurysms (range, 1.0-2.5 cm), four had left subclavian artery aneurysms, and four had ascending/arch aneurysms. The most common repair was resection of aortic coarctation with interposition graft replacement (93%). Two patients without aneurysm had bypasses from the proximal descending thoracic aorta to the infrarenal aorta without aortic resection. There was no in-hospital mortality, stroke, or paraplegia. Long-term survival was 89% during a median follow-up of 81 months (interquartile range, 47-118 months), with no patient requiring reoperation on the repaired segment. CONCLUSIONS: Open repair of native and recurrent adult aortic coarctation has acceptable morbidity and low mortality. Especially in patients with concomitant aneurysm, resection with interposition graft replacement provides a safe and durable repair option. Published by Elsevier Inc.
BACKGROUND: We report on our experience with treatment of adults requiring de novo or redo open aortic coarctation repair mostly by a resection and interposition graft technique. METHODS: We retrospectively reviewed all patients older than 16 years requiring open repair of aortic coarctation. Indications for repair, operative details, and outcomes were analyzed. RESULTS: Between 1996 and 2011, we treated 29 adult aortic coarctationpatients with open repair. The mean age was 42 years (range, 17-69 years), and there were 15 men. Nine patients had previous repair with recurrence; the remaining 20 had native coarctation. Thoracic aortic aneurysms were present in 22 patients (76%), ranging in size from 3.0 to 9.6 cm (mean, 4.8 cm). Four patients had intercostal artery aneurysms (range, 1.0-2.5 cm), four had left subclavian artery aneurysms, and four had ascending/arch aneurysms. The most common repair was resection of aortic coarctation with interposition graft replacement (93%). Two patients without aneurysm had bypasses from the proximal descending thoracic aorta to the infrarenal aorta without aortic resection. There was no in-hospital mortality, stroke, or paraplegia. Long-term survival was 89% during a median follow-up of 81 months (interquartile range, 47-118 months), with no patient requiring reoperation on the repaired segment. CONCLUSIONS: Open repair of native and recurrent adult aortic coarctation has acceptable morbidity and low mortality. Especially in patients with concomitant aneurysm, resection with interposition graft replacement provides a safe and durable repair option. Published by Elsevier Inc.
Authors: Ryszard Pogorzelski; Tomasz Wołoszko; Sadegh Toutounchi; Patryk Fiszer; Ewa Krajewska; Wawrzyniec Jakuczun; Małgorzata M Szostek; Krzysztof Celejewski; Zbigniew Gałązka Journal: Open Med (Wars) Date: 2017-03-23
Authors: Djamila Abjigitova; Mostafa M Mokhles; Maarten Witsenburg; Pieter C van de Woestijne; Jos A Bekkers; Ad J J C Bogers Journal: Eur J Cardiothorac Surg Date: 2019-12-01 Impact factor: 4.191