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Off-Pump Aortic Bypass for Hypoplastic Arch and Aortic Coarctation Via Anterolateral Thoracotomy
Li-Qun Chi1, Lin Liang1, Qing-Yu Kong1
1Department of Cardiac Surgery, 12667Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
A novel surgical approach for severe aortic coarctation in a young woman involved an off-pump bypass graft. This less invasive technique offers a safe alternative for complex aortic arch hypoplasia cases.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Aortic coarctation is a congenital narrowing of the aorta, often presenting with uncontrolled hypertension.
- Severe cases, particularly with aortic arch hypoplasia, pose significant surgical challenges.
Observation:
- A 21-year-old woman presented with refractory hypertension due to severe aortic coarctation and aortic arch hypoplasia.
- Computed tomography angiography confirmed the complex anatomy of the aortic arch.
Findings:
- An off-pump ascending-to-descending aortic bypass was successfully performed using a synthetic graft via left anterolateral thoracotomy.
- The procedure avoided manipulation of cerebral and collateral vessels, minimizing surgical risk.
Implications:
- This minimally invasive bypass technique represents a safe and effective alternative for adult patients with complex aortic coarctation and hypoplasia.
- The approach may reduce operative morbidity and improve outcomes in challenging aortic reconstruction cases.
Abstract:
We report the case of a 21-year-old woman who was referred with uncontrolled hypertension. Computed tomography angiography revealed aortic arch hypoplasia and severe aortic coarctation. An off-pump ascending-to-descending aortic bypass surgery using synthetic graft was performed via left anterolateral thoracotomy. The patient recovered well and was discharged home uneventfully after five days. This procedure was performed without touching the head vessels or any collateral vessels. We consider this a safe and less invasive alternative technique for adult coarctation patients who have aortic hypoplasia or interrupted aorta.
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