Reoperative approach after extra-anatomic ascending-to-descending aortic bypass graft.


Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
15 Jul 2024
Historique:
received: 12 03 2024
accepted: 30 06 2024
medline: 15 7 2024
pubmed: 15 7 2024
entrez: 14 7 2024
Statut: epublish

Résumé

Extra-anatomic ascending-to-descending aortic bypass grafts have historically been utilized as a safe and effective solution for repairs of complex coarctation of the aorta. However, reports on reoperation in these patients remain rare. We present a case of an aortic valve replacement and coronary artery bypass grafting in a patient with an extra-anatomic ascending-to-descending aortic bypass graft. The patient is a 59-year-old male with a complex aortic history, including repair of aortic coarctation with an ascending-to-descending aortic bypass graft 13 years prior, was admitted to the hospital for shortness of breath and chest pain that had developed over the past year. On further workup, he was found to have severe bileaflet aortic valve stenosis, non-ST elevation myocardial infarction, and moderate coronary artery disease. He underwent surgical aortic valve replacement and coronary artery bypass grafting. Given his unique anatomy, cardiopulmonary bypass approach involved separate cannulation of the right axillary and left common femoral arteries with cross-clamp of both the aorta and the extra-anatomic graft. Using this approach, the redo operation was successfully performed. Reports on reoperation after ascending-to-descending aortic bypass grafting are rare. We describe our approach to cardiopulmonary bypass and reoperation in a patient with an extra-anatomic ascending-to-descending aortic bypass graft.

Sections du résumé

BACKGROUND BACKGROUND
Extra-anatomic ascending-to-descending aortic bypass grafts have historically been utilized as a safe and effective solution for repairs of complex coarctation of the aorta. However, reports on reoperation in these patients remain rare. We present a case of an aortic valve replacement and coronary artery bypass grafting in a patient with an extra-anatomic ascending-to-descending aortic bypass graft.
CASE PRESENTATION METHODS
The patient is a 59-year-old male with a complex aortic history, including repair of aortic coarctation with an ascending-to-descending aortic bypass graft 13 years prior, was admitted to the hospital for shortness of breath and chest pain that had developed over the past year. On further workup, he was found to have severe bileaflet aortic valve stenosis, non-ST elevation myocardial infarction, and moderate coronary artery disease. He underwent surgical aortic valve replacement and coronary artery bypass grafting. Given his unique anatomy, cardiopulmonary bypass approach involved separate cannulation of the right axillary and left common femoral arteries with cross-clamp of both the aorta and the extra-anatomic graft. Using this approach, the redo operation was successfully performed.
CONCLUSIONS CONCLUSIONS
Reports on reoperation after ascending-to-descending aortic bypass grafting are rare. We describe our approach to cardiopulmonary bypass and reoperation in a patient with an extra-anatomic ascending-to-descending aortic bypass graft.

Identifiants

pubmed: 39004754
doi: 10.1186/s13019-024-02968-5
pii: 10.1186/s13019-024-02968-5
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

448

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Alice L Zhou (AL)

Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Zayed Tower, Baltimore, MD, 21287, USA.

Deven Patel (D)

Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Zayed Tower, Baltimore, MD, 21287, USA.

Michael P Robich (MP)

Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Zayed Tower, Baltimore, MD, 21287, USA. mrobich4@jhmi.edu.

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