Two-Stage Repair of Adult Coarctation of the Aorta With Congenital Valvular Lesions
Section snippets
Patient 1
A 26-year-old male drug addict was seen with congestive cardiac failure secondary to bacterial endocarditis. He was also noted to have coarctation of the aorta. Echocardiography revealed a stenotic aortic valve with a gradient of 125 mm Hg, moderate regurgitation, and aortic valve vegetations. An aortogram revealed coarctation of the aorta with a gradient of 55 mm Hg. Blood cultures grew Streptococcus faecalis, and a regimen of intravenous antibiotics was commenced. Despite aggressive antibiotic
Comment
The presentation of coarctation of the aorta in adulthood is rare. Associated congenital aortic and mitral valve lesions are extremely rare, and very little published data are available. The obvious problem for the surgeon is which management option to select: one-stage correction of both lesions simultaneously through a median sternotomy with valve replacement and an extraanatomic bypass graft from the ascending to the descending aorta 1., 2., 3. or a two-stage approach. In the latter, the
References (14)
- et al.
Perioperative complications in combined aortic valve replacement and extraanatomic ascending–descending bypass
Ann Thorac Surg
(1996) - et al.
Reoperation for aortic coarctation: techniques, results, and indications for various approaches
Ann Thorac Surg
(1985) - et al.
Ascending aorta-abdominal aorta bypass: indications, technique, and report of 12 patients
Ann Thorac Surg
(1977) - et al.
Coarctation of the aorta and severe aortic insufficiency: what to repair first?
Am J Surg
(1977) - et al.
Balloon dilatation of aortic coarctation [Letter; Comment]
Am Heart J
(1993) - et al.
Experimental subendocardial ischemia in dogs with normal coronary arteries
Circ Res
(1972) - et al.
Effect of aortic insufficiency on phasic flow patterns in the coronary artery
Ann Surg
(1966)