Three Cases of Ascending Aorta-Abdominal Aorta Bypass for Atypical Coarctation with Takayasu's Aortitis
10.4326/jjcvs.38.239
- VernacularTitle:高安動脈炎による異型大動脈縮窄症に対する上行大動脈-腹部大動脈バイパス術の3症例
- Author:
Eiichiro Inagaki
;
Sohei Hamanaka
;
Hitoshi Minami
;
Atsushi Tabuchi
;
Yasuhiro Yunoki
;
Hiroshi Kubo
;
Yuji Kanaoka
;
Mitsuaki Matsumoto
;
Hisao Masaki
;
Kazuo Tanemoto
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2009;38(4):239-243
- CountryJapan
- Language:Japanese
-
Abstract:
We report 3 cases of ascending aorta-abdominal aorta bypass for atypical coarctation with Takayasu's aortitis. We performed an extra-anatomical bypass from the ascending aorta to the terminal abdominal aorta. The graft was arranged to pass through the diaphragm from the pericardium, behind the left lobe of the liver and the stomach, to the front side of the pancreas to the terminal abdominal aorta. Although the graft was exposed in the abdominal cavity in part behind the stomach, it was completely covered with the great omentum thus avoiding direct contact between the graft the abdominal organs. Decrease in the pressure gradient between the ascending aorta and the abdominal aorta was achieved using a large prosthetic graft 14-16 mm in diameter. There are several advantages with this technique. (1) Positional change during surgery can be avoided. (2) Anastomosis can be performed in non-diseased vessels. (3) This bypass graft can be branched off to visceral arteries if necessary. Reduction of the after load on the left ventricle and long-term graft patency by using a large diameter prosthetic graft were anticipated. The postoperative courses of all cases were satisfactory. Case 1 died of another disease 11 years and 11 months postoperatively, but the graft to was still patent.
