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Off‐Pump Extraanatomic Bypass from the Ascending to the Descending Aorta for Re‐Operation of Interrupted Aortic Arch in an Adolescent
Author(s) -
Lang Nora,
Sodian Ralf,
Malec Edward,
Januszewska Katarzyna,
KozlikFeldmann Rainer,
Pozza Robert Dalla,
Huber Armin M.,
Abicht Jan,
Kowalski Christian,
Reichart Bruno,
Netz Heinrich,
Schmitz Christoph
Publication year - 2009
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2008.00798.x
Subject(s) - medicine , descending aorta , interrupted aortic arch , ascending aorta , arch , cardiology , aortic arch , aorta , civil engineering , engineering
The appearance of re‐stenosis after repair of an interrupted aortic arch may be a surgical challenge due to adhesions. Here, we describe an approach using off‐pump coronary artery bypass grafting techniques to reach the descending aorta through a median sternotomy in a patient with aortic arch stenosis after conduit repair. The 17‐year‐old patient with diagnoses of interrupted aortic arch and ventricular septal defect presented after two previous operations (one left lateral thoracotomy and one median sternotomy) with a stenosed vascular graft between ascending and descending aorta. Surgery was done via re‐sternotomy without cardio‐pulmonary bypass. An extraanatomic graft was used to connect ascending and descending aorta. When performing the distal anastomosis, the heart was exposed using a standard suction device. This case demonstrates that the use of modern techniques may facilitate surgical approaches dramatically. In our opinion the above‐described technique is the first choice for all patients requiring arch repair following multiple previous operations, performed via sternotomy and thoracotomy.