One-stage repair of aortic coarctation and ascending aortic aneurysm by extra-anatomic graft

Area of Science:

• Cardiovascular Surgery
• Aortic Diseases
• Congenital Heart Defects

Background:

• Optimal surgical strategy for coarctation of the aorta (CoA) with concurrent cardiovascular anomalies remains debated.
• Complex congenital heart disease often requires tailored, multi-faceted surgical interventions.
• Bicuspid aortic valve (BAV) and ascending aortic aneurysms are frequently associated with CoA.

Observation:

• A young male patient presented with a complex cardiac condition involving CoA, ascending aortic aneurysm, and moderate aortic insufficiency secondary to a BAV.
• The patient's anatomy necessitated a comprehensive surgical approach to address all pathologies simultaneously.
• A bicuspid aortic valve with moderate insufficiency was noted alongside the coarctation and aneurysm.

Findings:

• A successful single-stage surgical procedure was performed, involving replacement of the ascending aorta.
• The bicuspid aortic valve was repaired, and the coarctation of the aorta was bypassed using an extra-anatomic graft.
• This combined approach effectively managed the patient's multiple cardiovascular defects.

Implications:

• Ascending-to-descending extra-anatomic bypass grafting is presented as a feasible and effective solution for complex aortic coarctation cases.
• This surgical technique may offer a valuable option for patients with combined aortic pathologies, simplifying treatment pathways.
• Further research into the long-term outcomes of this approach in complex cardiovascular cases is warranted.