Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults

  • Ali Refatllari Department of Cardiovascular Surgery, University Hospital Centre “Mother Theresa”, Rruga e Dibres, N. 370, Tirana
  • Ermal Likaj Department of Cardiovascular Surgery, University Hospital Centre “Mother Theresa”, Rruga e Dibres, N. 370, Tirana
  • Selman Dumani Department of Cardiovascular Surgery, University Hospital Centre “Mother Theresa”, Rruga e Dibres, N. 370, Tirana
Keywords: coarctation, adults, bypass graft, hypertension, technique

Abstract

BACKGROUND: Coarctation represents 5-8% of congenital heart disease. Residual hypertension remains the main problem after late correction. Surgical treatment in the adult remains a challenge for the surgeon. Our prefered method used in this category is the Subclavian-aortic bypass.

MATERIAL AND METHODS: We have reviewed our registry for the period of 12 years (1998- 2010) and we found a group of 18 adult patients being operated for coarctation of the aorta. The mean age of this group of patients was 24.7 ± 8.43 years (range 16-42 years). 13 were males and 5 females.

RESULTS: Sugical technique: Most of the patients (13 pts, 72%) which were obviously treated with subclavian-aortic bypass with a Dacron prostheses. Mean preoperative and postoperative pressure gradients measured by echocardiography were 77.7 ± 20.16 mmHg and 22.3 ± 9.14 mmHg respectively. No mortality was observed in this series of patients. Chylothorax was the only complication observed in one patient in the early postoperative period.

CONCLUSION: Coarctation of the aorta in adults is treated with optimal early results at our surgical centre. Subclavian-aortic bypass grafting requires less aortic dissection, can be performed with a partially occluding clamp, and does not compromise the spinal cord vascularization.

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Published
2015-12-24
How to Cite
1.
Refatllari A, Likaj E, Dumani S. Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults. Open Access Maced J Med Sci [Internet]. 2015Dec.24 [cited 2020Dec.2];4(1):47-9. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2016.006
Section
B - Clinical Sciences