Late Complications After Previous Surgical Repair for Coarctation With Extra-Anatomic Bypass Graft: Report on Two...

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Vascular Surgery

Background:

• Surgical correction of aortic coarctation (CoA) is standard for infants and adolescents to prevent obstruction and hypoperfusion.
• Various CoA repair techniques exist, but late complications like re-CoA and pseudoaneurysms can occur.
• The incidence of complications is linked to the initial surgical approach.

Observation:

• This report details two cases of late complications following an extra-anatomical aortic bypass graft (EABG) for CoA.
• Case 1: Pseudoaneurysm at the distal anastomosis site treated with an endovascular stent graft.
• Case 2: Stenosis at the proximal anastomosis site with the left subclavian artery (LSCA), managed medically per patient request.

Findings:

• Extra-anatomical aortic bypass grafting (EABG), though infrequently used, can result in significant late complications.
• Pseudoaneurysm formation and stenosis at anastomosis sites are potential adverse outcomes.
• Treatment strategies for these complications vary, including endovascular repair and medical management.

Implications:

• These cases underscore the importance of considering the specific surgical technique's long-term risks in aortic coarctation repair.
• Careful patient selection and vigilant follow-up are crucial for managing potential complications of EABG.
• Further research into the long-term efficacy and safety of less common CoA repair methods is warranted.