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. 2018 Apr 20;24(2):97-102.
doi: 10.5761/atcs.oa.17-00167. Epub 2018 Feb 16.

Selection of a Surgical Treatment Approach for Aortic Coarctation in Adolescents and Adults

Eisaku Nakamura  1 , Kunihide Nakamura  1 , Koji Furukawa  1 , Hirohito Ishii  1 , Katsuya Kawagoe  1
Affiliations

Selection of a Surgical Treatment Approach for Aortic Coarctation in Adolescents and Adults

Eisaku Nakamura et al. Ann Thorac Cardiovasc Surg. .

Abstract

Purpose: Coarctation of the aorta (CoA) in adolescents and adults is relatively rare. Several operative techniques for CoA in adolescents and adults have been reported, but there is still no consensus. This study aims to highlight the use of individual patient characteristics to select optimal treatment strategies for CoA in adolescents and adults.

Methods: Surgical repair of CoA was performed in five patients (mean age: 34 ± 14 years, range: 13-58 years). All patients had primary CoA, and one had aneurysm above the CoA. One patient had undergone previous aortic valve replacement (AVR) and graft replacement of the ascending aorta. One patient underwent resection of the coarctation without cardiopulmonary bypass (CPB) followed by direct end-to-end anastomosis. Three patients underwent CoA resection with an interposition graft through a lateral thoracotomy with partial CPB. One patient underwent AVR with extra-anatomical bypass (ascending-descending aorta).

Results: No in-hospital deaths occurred, and there were no complications. During the follow-up period, there has been no recurrence of CoA.

Conclusion: CoA in adolescents and adults is associated with different issues from those encountered in infant patients, and comprehensive surgery should be performed in all cases.

Keywords: adolescents and adults; coarctation of the aorta; surgical treatment.

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Figures

Fig. 1
Fig. 1. Three-dimensional CT. (A) Preoperative view. (B) Postoperative view. A direct end-to-end anastomosis was performed. CT: computed tomography
Fig. 2
Fig. 2. Three-dimensional CT. (A) Preoperative view showing aneurysmal dilatation of the aorta above the aortic narrowing. (B) Postoperative view. Patient No. 3 underwent partial graft replacement of the aortic arch. CT: computed tomography
Fig. 3
Fig. 3. Three-dimensional CT. (A) Preoperative view. (B) Postoperative view. Patient No. 5 was treated with extraanatomical bypass (ascending–descending aorta). CT: computed tomography
See this image and copyright information in PMC

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