Surgical and haemodynamic considerations in middle aortic syndrome

Eleven patients with the middle aortic syndrome have been investigated during the past five years. Corrective surgery was possible in seven, five of whom survived. The maximum constriction in most cases was at the thoracoabdominal junction, an area normally surrounded by intestinal lymphatics. This may indicate that the aetiology is related to an immune response to parasitic infestation of the intestines. Comparison of the extent and severity of the disease as found at operation with the results of preoperative investigations such as angiography, radioisotope renography, and measurement of angiotensin in the renal veins showed that in some patients surgical exploration was more accurate in deciding the feasibility and the method of surgical correction.