Ascending-to-descending aortic bypass and aortic valve replacement for concomitant severe aortic coarctation and aortic stenosis

Vasc Endovascular Surg. 2011 Apr;45(3):303-6. doi: 10.1177/1538574410396589. Epub 2011 Jan 28.

Abstract

We present a 33-year-old male with severe, symptomatic aortic coarctation and aortic stenosis assessed on a humanitarian medical mission to a developing country. Contemplating limited time and available resources, we performed a simultaneous single-stage approach with ascending-to-descending aortic bypass with a reinforced gortex graft and concomitant aortic valve replacement through a median sternotomy. The patient had an uneventful postoperative convalescence and was discharged on postoperative day 5. At 1-year follow-up, he was asymptomatic and doing well with good blood pressure control and complete equalization of upper and lower limb blood pressure measurements. Computed tomography and transthoracic echocardiography demonstrated a widely patent ascending-to-descending aortic bypass graft and a normally functioning prosthetic aortic valve, respectively. In developing countries where health care resources are limited, a combined approach with an extra-anatomic, thoracic aortic bypass, and aortic valve replacement resulted in good early and 1-year outcomes. This procedure may represent the most effective surgical option for patients with concomitant aortic coarctation and aortic stenosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / physiopathology
  • Aorta, Thoracic / surgery*
  • Aortic Coarctation / complications
  • Aortic Coarctation / diagnosis
  • Aortic Coarctation / physiopathology
  • Aortic Coarctation / surgery*
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation*
  • Heart Valve Prosthesis Implantation*
  • Hemodynamics
  • Humans
  • Male
  • Severity of Illness Index
  • Sternotomy
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular Patency