Insertion of a bypass graft from carotid artery to descending aorta in the management of aortic coarctation with severe hypoplasia of the aortic arch—a report of two cases

1993 ◽  
Vol 3 (1) ◽  
pp. 76-78
Author(s):  
Ganga Prabhakar ◽  
Naresh Kumar ◽  
Zohair Al Halees ◽  
Neil Wilson
Keyword(s):  
Surgical Technique ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Bypass Graft ◽  
Descending Aorta ◽  
Residual Stenosis ◽  
Cardiac Abnormalities ◽  
Standard Procedures ◽  
The Individual

AbstractRepair of severe hypoplasia of the aortic arch with coarctation must be based on the individual anatomy of the lesion and, where necessary, one should take into consideration associated cardiac abnormalities. We report a surgical technique which was employed when standard procedures for reconstruction of the arch had failed to relieve the obstruction adequately. A conduit from the carotid artery to the descending aorta was used successfully in two patients to abolish residual stenosis.

Abnormal histology of the aortic arch in coarctation of the aorta

1993 ◽  
Vol 3 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Derk W. Wolterbeek ◽  
Arie P. Kappetein ◽  
Adriana C. Gittenberger–de Groot
Keyword(s):  
Neural Crest ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Lower Number ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Cardiac Neural Crest ◽  
The Media

SummaryWe examined the number of elastic lamellae in the wall of the proximal aortic arch, aortic isthmus and descending aorta in patients with coarctation of the aorta. In the proximal aortic arch, the number of elastic lamellae was significantly lower in patients with coarctation compared to those with normal hearts without aortic anomalies and those with intracardiac defects but without aortic anomalies. The isthmus also showed a significantly lower number of elastic lamellae in the presence of preductal coarctation. In the descending aorta, the number of elastic lamellae was not significantly different between the different groups. There is doubt about the etiology of coarctation. Recent investigations showed that cells from the cardiac neural crest contribute to the formation of the arch arteries and the media of the arch. A developmental error of the neural crest might be responsible for the abnormal mural structures found in patients with aortic coarctation.

Great Vessel Disease

2015 ◽  
Author(s):  
Thomas C. Bower ◽  
Kenneth J. Cherry Jr
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Bypass Graft ◽  
Graft Infection ◽  
Artery Aneurysm ◽  
Occlusive Disease ◽  
Aortic Aneurysms ◽  
Hybrid Technique ◽  
Elephant Trunk ◽  
Hybrid Techniques

The great vessels or supra-aortic trunks (SATs) are most often affected by occlusive disease. Aneurysms of the SATs are much rarer compared with other vascular territories and may be associated with aneurysms or dissections of the ascending aorta and arch or aneurysms in other locations. Treatment of SAT aneurysms has evolved from ligation or exclusion to aneurysm resection with autogenous or prosthetic interposition grafts. There is now a growing body of literature describing the use of endovascular techniques to treat occlusive disease or SAT aneurysms. Hybrid techniques, which combine SAT revascularization by direct or cervical routes with aortic stenting, have also grown in popularity. This review covers anatomy, etiology and aortic arch pathology, clinical presentation, diagnosis, indications for treatment, open reconstruction for occlusive lesions, extrathoracic arterial reconstruction, aortic arch repair, endovascular treatment, and prosthetic SAT graft infection or involvement by tumor. Tables outline distribution of atherosclerotic lesions and extended carotid artery aneurysm studies from 2005 to 2012. Figures show a small subclavian artery aneurysm, thromboembolic occlusion of the brachial and forearm arteries, and digital infarcts; sternal exposure; multivessel supra-aortic trunk reconstruction; a subclavian to carotid artery transposition; three-dimensional relationships of a retropharyngeal and an anteriorly tunneled carotid-carotid bypass; an ascending aortic and total arch repair using an elephant trunk; distal arch and descending thoracic aortic aneurysms with chronic dissection treated with a hybrid technique; complex redo aortic coarctation and SAT reconstruction; hybrid repair of a developmental aortic arch abnormality, a large aberrant right subclavian aneurysm, and Kommerell diverticulum; infection of an ascending aortobilateral distal carotid prosthetic bypass graft originally placed for Takayasu arteritis; and an angiosarcoma involving the innominate, right subclavian, and cervical common carotid arteries and the internal jugular vein. This review contains 11 figures, 2 tables, and 81 references.

scholarly journals Persistent fifth aortic arch associated with aortic coarctation: a case of surgical correction without artificial material

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chang Hun Kim ◽  
Hyungtae Kim ◽  
Kwang Ho Choi ◽  
Si Chan Sung ◽  
Hoon Ko ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Coarctation ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Growth Potential ◽  
Case Presentation ◽  
Descending Aorta ◽  
Persistent Fifth Aortic Arch ◽  
Additional Surgery ◽  
Surgical Methods

Abstract Background Persistent fifth aortic arch (PFAA) is a rare anomaly often associated with aortic coarctation or interruption, and various surgical techniques for this anomaly have been reported. Herein, we show a case of an infant with PFAA and severe aortic coarctation. Case presentation A 41-day-old female infant was admitted for sustained fever. Initially, the patient was diagnosed with bacterial meningitis, and echocardiography showed PFAA with severe aortic coarctation. Because the patient presented progressive oliguria and metabolic acidosis, she was transferred for emergency cardiac surgical intervention. The aortic arch was reconstructed using end-to-side anastomosis between the fifth aortic arch and the descending aorta without any artificial conduit or patching material. Conclusions PFAA with aortic coarctation can be repaired by various surgical methods. Among them, our surgical approach is easy and effective, has growth potential, and an additional surgery is not needed.

A surgical technique for ascending aorta, aortic arch and descending aorta replacement without cross-clamp, circulatory arrest or hypothermia

2020 ◽  
Vol 30 (1) ◽  
pp. 24-27
Author(s):  
Murat Ugurlucan ◽  
Yahya Yildiz ◽  
Mustafa O. Ulukan ◽  
Didem M. Oztas ◽  
Metin O. Beyaz ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Ascending Aorta ◽  
Whole Body ◽  
Surgical Reconstruction ◽  
Descending Aorta ◽  
Bloodless Field ◽  
Aorta Replacement ◽  
Selective Cannulation

AbstractTreatment of the aneurysms comprising the aortic arch is challenging. Surgical reconstruction usually requires aortic cross-clamping, cardiac arrest, and even deep hypothermia for a bloodless field. In this report, we present our surgical technique providing normothermic ascending aorta, aortic arch, and proximal descending aorta replacement with selective cannulation and perfusion of the whole body.

scholarly journals Persistent Fifth Aortic Arch Associated With Aortic Coarctation: A Case of Surgical Correction Without Artificial Material

2021 ◽  
Author(s):  
Chang Hun Kim ◽  
Hyungtae Kim ◽  
Kwang Ho Choi ◽  
Si Chan Sung ◽  
Hoon Ko ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Coarctation ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Growth Potential ◽  
Case Presentation ◽  
Descending Aorta ◽  
Persistent Fifth Aortic Arch ◽  
Additional Surgery ◽  
Surgical Methods

Abstract Background: Persistent fifth aortic arch (PFAA) is a rare anomaly often associated with aortic coarctation or interruption, and various surgical techniques for this anomaly have been reported. Herein, we show a case of an infant with PFAA and severe aortic coarctation. Case presentation: A 41-day-old female infant was admitted for sustained fever. Initially, the patient was diagnosed with bacterial meningitis, and echocardiography showed PFAA with severe aortic coarctation. Because the patient presented progressive oliguria and metabolic acidosis, she was transferred for emergency cardiac surgical intervention. The aortic arch was reconstructed using end-to-side anastomosis between the fifth aortic arch and the descending aorta without any artificial conduit or patching material. Conclusions: PFAA with aortic coarctation can be repaired by various surgical methods. Among them, our surgical approach is easy and effective, has growth potential, and an additional surgery is not needed.

scholarly journals Surgical treatment of double-lumen aortic arch (persistent fifth aortic arch) associated with severe aortic coarctation

2020 ◽  
Author(s):  
Chang Hun Kim ◽  
Hyungtae Kim ◽  
Kwang Ho Choi ◽  
Si Chan Sung ◽  
Hoon Ko
Keyword(s):  
Surgical Treatment ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Surgical Techniques ◽  
Growth Potential ◽  
Double Lumen ◽  
Descending Aorta ◽  
Persistent Fifth Aortic Arch ◽  
Rare Anomaly ◽  
Additional Surgery

Persistent fifth aortic arch (PFAA) is a rare anomaly often associated with aortic coarctation or interruption, and various surgical techniques for this anomaly have been reported. Herein, we show a case of an infant with PFAA and severe aortic coarctation. The aortic arch was reconstructed using end-to-side anastomosis between the fifth aortic arch and the descending aorta without any artificial conduit or patching material. This approach is easy and effective, has growth potential, and an additional surgery is not needed in the future.

Interrupted fourth aortic arch with persistent fifth aortic arch and aortic coarctation—treatment with balloon angioplasty combined with surgery

1994 ◽  
Vol 4 (3) ◽  
pp. 304-306 ◽  
Author(s):  
Raul Jurí ◽  
Luis Eduardo Alday ◽  
Roberto De Rossi
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Balloon Angioplasty ◽  
Aortic Coarctation ◽  
Left Subclavian Artery ◽  
Balloon Dilation ◽  
Descending Aorta ◽  
Persistent Fifth Aortic Arch

AbstractA symptomatic neonate was referred for aortic coarctation and, at cineangiography, was shown to have an interruption of the aortic arch at the isthmus together with coarctation related to a persistent fifth aortic arch. Balloon dilation of the coarctation was performed, but the coarctation was still evident after six months. A graft was then interposed between the left subclavian artery and the descending aorta. Balloon dilation was repeated five years later leaving a residual gradient of 11 mm Hg.

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

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