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Results for “AORTIC COARCTATION”

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At least 19 recordsLinked to original sources
PubMed1995

Aortic coarctation, aortic valvular stenosis, and coronary artery disease: combined one-stage surgical therapy operation.

The presentation of simultaneous severe coarctation of the descending aorta and severe aortic valve disease is uncommon. We describe the management of simultaneous association of aortic coarctation, aortic valve disease, and ischemic cardiomyopathy and describe a one-stage surgical approach for the correction of all pathologies. After performing the aortic valve replacement and myocardial revascularization, coarctation was solved by means of a prosthesis between the ascending aorta and the abdominal aorta. There were no evidence of myocardial ischemia during exercise testing and the blood pressure is normal.

Aorta, Abdominal↗
PubMed1984

Changes in regional vascular resistance in canine aortic coarctation.

Aortic coarctation was created experimentally in dogs and regional blood flows were measured at various times thereafter with radioactive microspheres in the conscious state. Mean arterial pressure increased moderately proximal to the stenosis, whereas distally it was reduced below control immediately, returning progressively toward control over 28 days. Blood flows were compared in tissues that are found both proximally and distally (skeletal muscles, skin and bones). In several groups of muscles located in the anterior part of the body, vascular conductance increased during the first hours after coarctation, then decreased below control. A similar pattern was observed in muscles of the hind leg. In the skin and in the bones of the front leg and of the hind leg, vascular conductance also increased in the early stages and decreased during the late stages. It therefore appears that aortic coarctation in dogs is characterized by a late generalized decrease in vascular conductance that extends to tissues which are never exposed to increased arterial pressure. These findings suggest that a systemic vasoconstrictor influence (possibly the measured increase in plasma renin activity) overrides local mechanisms in the control of regional circulations.

Animals↗
PubMedDate not supplied

Klippel-Feil syndrome associated with aortic coarctation.

Aortic coarctation was diagnosed in a 27-year-old man with Klippel-Feil syndrome, an inborn skeletal defect of the vertebral column associated with anomalies of various organs. The presented findings are discussed in the context to the theory of vascular artery supply disruption sequence during embryogenisis as a potential explanation for the pathogenesis of morphological defects of Klippel-Feil and associated syndromes.

Adult↗
PubMed2003

Single-stage treatment of aortic coarctation and aortic valve disease.

Surgical management of thoracic aortic coarctation associated with severe aortic valve disease is difficult in most cases. As staged procedures are associated with a higher rate of morbidity and mortality, simultaneous operative management of both lesions is desirable. From 1997 to 2001, 9 patients (8 males and 1 female with a mean age of 30.1 +/- 10.4 years) with this condition underwent simultaneous ascending aorta-infrarenal abdominal aorta bypass graft and aortic valve replacement. One patient died from failure of the extracorporeal circulation during the operation. Another patient suffered from partial intestinal obstruction in the early postoperative period but was successfully treated. The underlying pathology was successfully corrected in the 8 surviving patients, whose blood pressure in the upper limbs was reduced while that in the lower limbs rose. Being easier to manage, the single-stage approach with extraanatomic bypass is safe and effective for managing this aortic complication.

Adolescent↗
PubMedDate not supplied

Abdominal aortic coarctation inducing aortic occlusion and renovascular hypertension.

Abdominal aortic coarctation is a rare, non-atherosclerotic disease. It is a functionally significant at an early age when associated with aortic branch stenosis and renovascular hypertension. The pathogenesis of aortic constrictive lesions remains unknown, but may be related to developmental error or aortic growth arrest and various hypotheses have been reported. When the renal arteries are involved by the coarctation, severe hypertension is common at an early age and in untreated patients, life-threatening complications commonly occur. Patients who reach the age of 40 years generally have the coarctation below the renal arteries but even when the renal arteries are not involved by the coarctation, renovascular disease may still occur due to secondary atherosclerosis. Aortic thrombosis secondary to abdominal aortic coarctation with renovascular disease and lower limb ischemia, occurring in a 63-year old woman, is reported.

Aorta, Abdominal↗
PubMed1998

Complications following reparative surgery for aortic coarctation or interrupted aortic arch.

Repair of aortic coarctation or interrupted aortic arch continues to be associated with major long-term morbidity. Thus, we conducted a review of 87 consecutive patients who underwent aortic arch repairs, focusing particular attention on the complications that developed. A two-stage strategy was employed if cardiac lesions were associated. The median age at surgery was 1.5 months with a range of 12 h to 56 years. The aortic arch was repaired using end-to-end anastomosis, subclavian flap aortoplasty, subclavian arterial turning-down aortoplasty, patch aortoplasty, tube graft interposition, or other methods. There were 10 patients who died soon after repair, and all of whom had complex cardiac anomalies. Of the remaining 77 patients, 8 developed recurrent stenosis. These 8 patients were all similar in age, being under 3 months old, and weighing 4 kg or less. A multivariable analysis of the infants identified interrupted aortic arch as an independent risk factor for the development of this complication with an odds ratio of 6.45. Complications following prosthesis-free techniques were similar in prevalence and timing. All reinterventions were mortality-free, but catheter dilation and patch aortoplasty were not always successful. Three extraanatomic bypasses were successfully performed, and one adult who had undergone a previous graft and pseudoaneurysm operation was successfully treated with an extraanatomic bypass. These findings led us to conclude that the initial repair should be performed without a prosthesis, and that reintervention for stenosis should combine catheter dilation and extraanatomic bypass.

Adolescent↗
PubMed1996

Cor triatriatum sinistrum, aortic coarctation and bicuspid aortic stenosis in an adult.

Cardiac anomalies are usually diagnosed early in life, which is particularly true for their various combinations. The diagnosis in adulthood is rare. Here we report the case of a young man with an aortic coarctation corrected at the age of 16, however the associated stenotic bicuspid aortic valve and cor triatriatum sinistrum were corrected after Streptococcus viridans endocarditis 7 years later.

Abnormalities, Multiple↗
PubMed1994

Influence of age on survival, late hypertension, and recoarctation in elective aortic coarctation repair. Including long-term results after elective aortic coarctation repair with a follow-up from 25 to 44 years.

The optimal age for elective repair of aortic coarctation is controversial. The optimal age should be associated with a minimal risk of recoarctation, late hypertension, and other cardiovascular disorders. The purpose of this retrospective study is to determine the actuarial survival after aortic coarctation repair 25 years or more after operation and to calculate the optimal age for elective aortic coarctation repair. From 1948 to 1966, 120 consecutive patients underwent aortic coarctation repair. Eighty-seven were male (72.5%). The mean age at operation was 15.5 years (SD +/- 9.1 years). Resection and end-to-end anastomosis was performed in 103 patients (85.8%). Early mortality occurred in 6 patients as a result of surgical problems, whereas late mortality in 15 patients was predominantly caused by cardiac causes. The mean follow-up period was 32 years (range 25 to 44.2 years). Ninety-two patients 96.8%) were in New York Heart Association class I. The probability of survival 44 years after operation was 73%. Patients younger than 10 years at operation had the highest probability of survival at 97%. Multivariate analysis produced age at operation as the only incremental risk factor for the occurrence of recoarctation, of late hypertension, and of premature death. So that these sequelae can be avoided, elective aortic coarctation repair should be performed around 1.5 years of age. At that age, the probability of recoarctation will have decreased to less than 3%, and the probability of upper body normotension and long-term survival will be optimal.

Actuarial Analysis↗
PubMed1988

Aortic coarctation with hypoplastic aortic arch. Results of extended end-to-end aortic arch anastomosis.

Between 1980 and 1986, 80 infants (less than or equal to 3 months old) with symptomatic aortic coarctation and associated severe tubular hypoplasia of the transverse aortic arch underwent surgical treatment. Extended end-to-end aortic arch anastomosis was used in an attempt to correct both the isthmic stenosis and the hypoplasia of the transverse arch. After complete excision of the coarctation tissue, a long incision was made in the inferior aspect of the aortic arch, which was then anastomosed to the obliquely trimmed distal aorta. Pure coarctation was present in 17 patients (group I); 24 infants had an additional ventricular septal defect (group II), and 39 patients had associated complex heart disease (group III). The overall early mortality rate was 26% (confidence limits 21% to 32%) (18% in group I, 17% in group II, and 36% in group III). The early risk declined with time and was 18% (confidence limits 12% to 26%) for the last 2 years (seven deaths in 39 patients). Follow-up was 100% for a mean of 19 months. Actuarial survival rate at 3 years was 82% for group I, 78% for group II, and 32% for group III. Recurrent coarctation (gradient greater than or equal to 20 mm Hg) occurred in six operative survivors (10%, confidence limits 6% to 16%) and necessitated reoperation in three. Freedom from recoarctation at 4 years was 88%. Because extended end-to-end aortic arch anastomosis provides adequate correction of the aortic obstruction and entails a low risk of restenosis, it is our procedure of choice in infants with coarctation and severe hypoplasia of the aortic arch.

Actuarial Analysis↗
PubMed1976

Surgical management of severe aortic coarctation and interrupted aortic arch in neonates.

Forty-four infants, 2 to 90 days of age, with severe obstructive lesions of the aortic arch, underwent emergency surgical correction between Jan. 1, 1966, and April 1, 1975. The typical clinical presentation was severe congestive heart failure and acidemia. Resection of an aortic coarctation with end-to-end anastomosis was performed in 31 patients. Eight (26 per cent) died after the operation. Since 1969, the mortality rate has been reduced to 14 per cent (3 of 22 patients) even though the incidence of major associated cardiac lesions has remained essentially constant (56 per cent from 1966 through 1969, 64 per cent from 1970 through March, 1975). This suggests that the higher survival rate has resulted from improved surgical techniques and postoperative care. The mortality rate in the infants operated upon during the second and third months of life was twice as high as that in those operated upon before the age of 1 month. Eight patients with Type A interrupted aortic arch were operated upon and 5 survived. Five patients with Type B aortic arch were operated upon and 3 survived.

Aorta↗