Abstract
Seven patients with atypical coarctation of the aorta were treated with a long thoracoabdominal bypass graft. One of them had a right renal bypass at the same time. One patient who had undergone a patch angioplasty 4 years previously died of bleeding at the time of surgery. Five out of 6 patients who survived the operation have remained normotensive and free of symptoms for up to 12 years, with an average followup period of 4 years. One patient died 3 1/2 years postoperatively from rupture of a pseudoaneurysm. Our experience indicates that atypical coarctation of the elongated type can be treated satisfactorily by the long thoracoabdominal bypass graft. If associated lesions of renal stenosis are present, renal revascularization is also necessary to overcome hypertension.
Résumé
Chez 7 malades atteints de coarctation aortique atypique, nous avons réalisé un long bypass thoracoabdominal. Chez l'un d'entre eux, un bypass rénal droit a été fait en même temps. Un malade, qui avait eu une angioplastie d'élargissement 4 ans auparavant, est mort d'hémorragie peropératoire. Sur les 6 survivants, 5 sont restés sans symptome et avec une tension artérielle normale pendant une moyenne de 4 ans (maximum 12 ans de follow-up). Un malade est mort après 3 1/2 ans de rupture d'un faux anévrisme. Notre expérience montre que les longues coarctations atypiques peuvent être traitées de façon satisfaisante par un long bypass thoraco-abdominal. S'il existe des sténoses associées des artères rénales, il faut en même temps revasculariser le rein pour corriger l'hypertension.
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Wada, J., Kazui, T. Long-term results of thoracoabdominal bypass graft for atypical coarctation of the aorta. World J. Surg. 2, 891–896 (1978). https://doi.org/10.1007/BF01556550
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DOI: https://doi.org/10.1007/BF01556550