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The Journal of Cardiovascular Surgery 1998 August;39(4):483-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Coarctation of the tho­ra­co-abdom­i­nal aor­ta: operative treat­ment ­with a cryo­pre­served arte­ri­al homo­graft in a sev­en-­year-old boy

Wozniak G., Bauer J.*, Bohle R. M.**, Dapper F.

From the Department of Cardiovascular Surgery, *Department of Pediatric Cardiology, **Department of Pathology, Justus-Liebig-University, Gieβen, Germany


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Compared to coarc­ta­tion in the prox­i­mal descend­ing aor­ta ­near the inser­tion of the lig­a­men­tum arter­i­o­sum, coarc­ta­tion in the aor­tic ­arch, the low­er descend­ing or the abdom­i­nal aor­ta is a rel­a­tive­ly ­rare dis­ease. Operative treat­ment of abdom­i­nal coarc­ta­tion is ­more com­pli­cat­ed if ­there are con­com­i­tant ste­nos­es of vis­cer­al or ­renal arter­ies. In ­young ­patients, sur­gi­cal pro­ce­dure and out­come is addi­tion­al­ly deter­mined by cal­i­ber and com­pli­ance mis­match ­between ­still grow­ing ­native ves­sels and arte­ri­al sub­sti­tute. Our ­report ­deals ­with a sev­en-year-old ­male ­patient, who was ­first diag­nosed as hav­ing coarc­ta­tion of the aor­ta at ­five ­years of age due to dis­tinct bilat­er­al bra­chi­al hyper­ten­sion. The angio­gram ­revealed a nar­row­ing of the aor­ta, approx­i­mate­ly ten cen­ti­me­ters in ­length, ­from the low­er descend­ing seg­ment ­down to the prox­i­mal abdom­i­nal ­part of the aor­ta. The ori­gin of the super­i­or mes­en­ter­ic ­artery and ­both ­renal arter­ies ­were not ­involved in the path­o­log­i­cal pro­cess. Arterial recon­struc­tion was car­ried out by anas­tom­o­sis of cryo­pre­served arte­ri­al homo­graft ­with the tho­rac­ic aor­ta and ­with the abdom­i­nal aor­ta dis­tal to the ori­gin of the ­renal arter­ies. The post­op­er­a­tive ­course was unevent­ful, duplex­so­nog­ra­phy ­revealed no pres­sure gra­di­ent ­between the tho­rac­ic and abdom­i­nal aor­ta and bra­chi­al ­blood pres­sure was with­in nor­mal rang­es.

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