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. 2021 Dec;9(6):228-230.
doi: 10.1055/s-0041-1739483. Epub 2021 Dec 28.

Role of Extra-anatomic Ascending to Descending Bypass in Complex Thoracic Aortic Pathology

Mariano Camporrotondo  1 , Sebastian Pagni  2
Affiliations

Role of Extra-anatomic Ascending to Descending Bypass in Complex Thoracic Aortic Pathology

Mariano Camporrotondo et al. Aorta (Stamford). 2021 Dec.

Abstract

Complex pathology of the distal arch and proximal descending thoracic aorta is usually approached by stent endografting or in situ graft replacement. Oftentimes, these options are not feasible due to unfavorable anatomy, multiple previous procedures, active infection, or presence of concomitant cardiac disease. Thoracic aortic extra-anatomic bypass, as part of an open surgical strategy, is a useful and often the only curative option left for the treatment in these patients. Herein, we describe two cases that illustrate the utility of extra-anatomic thoracic aortic bypass for complex aortic disease.

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Conflict of interest statement

The authors declare no conflict of interest related to this article.

Figures

Fig. 1
Fig. 1
( A ) Posterior view of preoperative computed tomography scan that shows severe kinking of the descending aorta Dacron graft. ( B ) Surgical view of the descending aorta anastomosis with the heart stabilizers in place, and ( C ) after the surgery is completed with the ascending to descending bypass graft.
Fig. 2
Fig. 2
( A ) Computed tomography angiography shows mediastinal infection with fat stranding and perianeurysm contrast extravasation (arrow). The three-dimensional reconstruction reveals the proximal false aneurysm (inset—white arrow). ( B ) Stage-1 repair with ascending to descending bypass graft, ascending aorta to carotid bypass, previous carotid-subclavian bypass, and arch interruption and resection of the previous stent graft. ( C ) Final anatomy after surgical repair with extra-anatomic aortic bypass, stent graft, and descending aorta resection.
See this image and copyright information in PMC

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