Aortic valvular insufficiency and postductal aortic coarctation with small aorta syndrome: one-stage surgical management using extra anatomic bypass through median sternotomy |
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Authors: | Toru Mizumoto Toshiya Tokui Takane Hiraiwa Tosihiko Kinoshita and Hideki Fujii |
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Institution: | (1) Department of Thoracic Surgery, Anjo Kosei Hospital, Anjo, Aichi, Japan;(2) Present address: Department of Thoracic and Cardiovascular Surgery, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu Wakayama, 647-0072, Japan |
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Abstract: | A 30-year-old man who had undergone repair for coarctation of the thoracic aorta at age 7 and mitral valve annuloplasty at
age 9 was admitted for shortness of breath and claudication of both lower legs. The preoperative angiogram showed severe aortic
regurgitation, moderate coarctation of the thoracic aorta beyond the left subclavian artery, a degree of hypoplasia of the
infrarenal abdominal aorta, and total occlusion of both external iliac arteries. Aortic valve replacement, ascending-to-bilateral
femoral arterial bypass, and end expanded polytetra fluoro ethylene (ePTFE) graft-to-descending aorta bypass was performed
via a median sternotomy. Ascending-to-descending aortic bypass via the posterior pericardium allows simultaneous intracardiac
repair or an alternative approach for the patient with complex coarctation. |
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Keywords: | Aortic valvular insufficiency Aortic coarctation Small aorta syndrome Ascending aorta-bifemoral bypass |
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