One Stage Surgery in an Elderly Patient with Aortic Coarctation and Heart Disease
10.4326/jjcvs.42.471
- VernacularTitle:心房中隔欠損症，三尖弁閉鎖不全症，心房細動を合併した高齢者大動脈縮窄症の一期的手術例
- Author:
Hiroko Okuda
;
Yoshihiro Shimizu
;
Takeshi Ikuta
;
Shinsuke Kotani
;
Hirofumi Fujii
- Publication Type:Journal Article
- Keywords:
coarctation of the aorta;
elderly patient;
late diagnosis;
one-stage surgery;
extra-anatomic bypass
- From:Japanese Journal of Cardiovascular Surgery
2013;42(6):471-474
- CountryJapan
- Language:Japanese
-
Abstract:
A 78-year-old woman had been undergoing medical treatment for hypertension since she delivered a son in her early twenties. Three months previously, she was admitted with heart failure. She had felt leg fatigue for a long time, and the pressure gradient between the upper and lower limbs was about 60 mmHg. On further examinations, she was found to have an atrial septal defect (ASD), tricuspid valve regurgitation, atrial fibrillation, and severe coarctation of the aorta (CoA) with well-developed collateral arteries. We performed ASD closure, tricuspid annuloplasty with a flexible ring, left atrial maze operation and extra-anatomic bypass from the ascending to the abdominal aorta through a median sternotomy and upper median laparotomy. She had no postoperative complications and the pressure gradient between the upper and lower limbs improved remarkably postoperatively. It is rare for a patient over 70 years old who for the first time was given a diagnosis of CoA and ASD with other heart disease and who underwent surgical correction. We think one stage surgery with extra-anatomic bypass from the ascending to the abdominal aorta is a safe and effective technique for patients suffering CoA with heart disease.
