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Updated: May 30, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
New technique for single-staged repair of aortic coarctation and coexisting cardiac disorder
Askin Ali Korkmaz1, Mustafa Guden, Burak Onan
1Department of Cardiovascular Surgery, Sema Hospital, Istanbul, Turkey. aakorkmaz@gmail.com
Insights
Single-stage aortic coarctation repair using arch-to-descending aorta bypass grafting is a safe and effective surgical option. This approach reduces complications and mortality compared to staged procedures for complex cardiac conditions.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Management of adults with aortic coarctation and coexisting cardiac disorders presents surgical challenges.
- Single-staged procedures offer improved outcomes over two-staged approaches.
Purpose of the Study:
- To evaluate the efficacy of single-staged arch-to-descending aorta bypass grafting combined with intracardiac or ascending aortic aneurysm repair.
- To present surgical experience and outcomes in selected patients.
Main Methods:
- Retrospective review of 5 patients undergoing median sternotomy for arch-to-descending aorta bypass grafting and concomitant cardiac repair (October 2004 - April 2010).
- Indications included aortic coarctation with mitral insufficiency, ascending aortic aneurysm, or coronary artery disease.
Main Results:
- No early or late mortality observed in the study cohort.
- All bypass grafts remained patent with no graft-related complications or reoperations during a mean follow-up of 34.8 months.
- Successful single-stage repair was achieved for complex aortic coarctation with associated cardiac conditions.
Conclusions:
- Arch-to-descending aorta bypass grafting via median sternotomy is a viable alternative for selected adult patients requiring single-staged repair of aortic coarctation and concurrent cardiac disorders.
- This single-stage approach demonstrates excellent early and midterm results.
Abstract:
The management of adults with aortic coarctation and a coexisting cardiac disorder is still a surgical challenge. Single-staged procedures have lower postoperative morbidity and mortality rates than do 2-staged procedures. We present our experience with arch-to-descending aorta bypass grafting in combination with intracardiac or ascending aortic aneurysm repair.From October 2004 through April 2010, 5 patients (4 men, 1 woman; mean age, 45.8 ± 9.4 yr) underwent anatomic bypass grafting of the arch to the descending aorta through a median sternotomy and concomitant repair of an intracardiac disorder or an ascending aortic aneurysm. Operative indications included coarctation of the aorta in all cases, together with severe mitral insufficiency arising from damaged chordae tendineae in 2 patients, ascending aortic aneurysm with aortic regurgitation in 2 patients, and coronary artery disease in 1 patient. Data from early and midterm follow-up were reviewed.There was no early or late death. Follow-up was complete for all patients, and the mean follow-up period was 34.8 ± 18 months (range, 18 mo-5 yr). All grafts were patent. No late graft-related sequelae or reoperations were observed.For single-staged repair of aortic coarctation with a coexistent cardiac disorder, we propose arch-to-descending aorta bypass through a median sternotomy as an alternative for selected patients.
