Intermediate-term results of ascending–descending posterior pericardial bypass of complex aortic coarctation

Objective Extra-anatomic bypass of complex thoracic aortic disease through a median sternotomy has been reported as a safe alternative to thoracotomy. Our objective was to examine intermediate-term outcomes. Methods We retrospectively reviewed 50 consecutive patients with congenital aortic coarctation or recurrent coarctation who underwent ascending–descending posterior pericardial aortic bypass between January 1985 and November 2005. Demographic data, in-hospital and postoperative morbidity and mortality, and resolution of hypertension were determined by examination of the medical record. Results The mean age at operation was 42 years; 27 (54%) were men. There were no perioperative deaths. Upper-extremity blood pressure after coarctation repair with ascending–descending aortic bypass was significantly improved. Mean systolic blood pressure decreased from 158 ± 25 mm Hg preoperatively to 123 ± 14 mm Hg postoperatively ( P < .001). There were no graft-related deaths or complications in follow-up extending up to 20 years. Conclusions The ascending–descending aortic bypass through a posterior pericardial approach is a safe operation and is effective in relieving obstruction and improving hypertension.