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 coarctati...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2007-06, Vol.133 (6), p.1504-1509 |
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| creator | McKellar, Stephen H., MD Schaff, Hartzell V., MD Dearani, Joseph A., MD Daly, Richard C., MD Mullany, Charles J., MBMS Orszulak, Thomas A., MD Sundt, Thoralf M., MD Connolly, Heidi M., MD Warnes, Carole A., MD Puga, Francisco J., MD |
| description | 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. |
| doi_str_mv | 10.1016/j.jtcvs.2006.11.011 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70554931</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522306021283</els_id><sourcerecordid>70554931</sourcerecordid><originalsourceid>FETCH-LOGICAL-c586t-acf987b7ee7efd931908b26ce811c12e5d9c91dd647058d33970c0c9dc15b3263</originalsourceid><addsrcrecordid>eNqFks2K1UAQhYMoznX0CQTJRnGTWNV987dQkMGfgQEXKrhrOp3KTMe-6didjN6d7-Ab-iRW5l4ZcOOquuE7p4pTlSSPEXIELF8M-TCb65gLgDJHzAHxTrJBaKqsrIsvd5MNgBBZIYQ8SR7EOABABdjcT06wKqRotvUmGc_HmcKOOqtnytZnGigubo6p71MdDY2dHS9___zV0d9POvnIpPUhnbgYHVjt0nY_6XgjM343OfqRah9ma_irg5n1bP34MLnXaxfp0bGeJp_fvvl09j67-PDu_Oz1RWaKupwzbfqmrtqKqKK-ayQ2ULeiNFQjGhRUdI1psOvKbQVF3UnZVGDANJ3BopWilKfJs4PvFPy3heKsdpbHd06P5JeoWFZs2ZdBeQBN8DEG6tUU7E6HvUJQa8xqUDcxqzVmhag4ZlY9OdovLWd3qznmysDTI8ARatcHPRobb7m6FhJQMPf8wF3Zy6vvNpCKO-0c2-LaNqKUirsWsGX05QElzu3aUlDRWBoNry6QmVXn7X9mfvWP3jg78vbcV9pTHPwSRl6JQhWFAvVxPZ71dqAEgaKW8g9JzcKD</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70554931</pqid></control><display><type>article</type><title>Intermediate-term results of ascending–descending posterior pericardial bypass of complex aortic coarctation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>McKellar, Stephen H., MD ; Schaff, Hartzell V., MD ; Dearani, Joseph A., MD ; Daly, Richard C., MD ; Mullany, Charles J., MBMS ; Orszulak, Thomas A., MD ; Sundt, Thoralf M., MD ; Connolly, Heidi M., MD ; Warnes, Carole A., MD ; Puga, Francisco J., MD</creator><creatorcontrib>McKellar, Stephen H., MD ; Schaff, Hartzell V., MD ; Dearani, Joseph A., MD ; Daly, Richard C., MD ; Mullany, Charles J., MBMS ; Orszulak, Thomas A., MD ; Sundt, Thoralf M., MD ; Connolly, Heidi M., MD ; Warnes, Carole A., MD ; Puga, Francisco J., MD</creatorcontrib><description>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.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2006.11.011</identifier><identifier>PMID: 17532948</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aorta, Thoracic - surgery ; Aortic Coarctation - complications ; Aortic Coarctation - surgery ; Aortography ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Cardiovascular Surgical Procedures - methods ; Diseases of the aorta ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Humans ; Hypertension - etiology ; Hypertension - surgery ; Magnetic Resonance Angiography ; Male ; Medical sciences ; Middle Aged ; Recurrence ; Retrospective Studies ; Sternum - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Treatment Outcome</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2007-06, Vol.133 (6), p.1504-1509</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2007 The American Association for Thoracic Surgery</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c586t-acf987b7ee7efd931908b26ce811c12e5d9c91dd647058d33970c0c9dc15b3263</citedby><cites>FETCH-LOGICAL-c586t-acf987b7ee7efd931908b26ce811c12e5d9c91dd647058d33970c0c9dc15b3263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2006.11.011$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18823012$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17532948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McKellar, Stephen H., MD</creatorcontrib><creatorcontrib>Schaff, Hartzell V., MD</creatorcontrib><creatorcontrib>Dearani, Joseph A., MD</creatorcontrib><creatorcontrib>Daly, Richard C., MD</creatorcontrib><creatorcontrib>Mullany, Charles J., MBMS</creatorcontrib><creatorcontrib>Orszulak, Thomas A., MD</creatorcontrib><creatorcontrib>Sundt, Thoralf M., MD</creatorcontrib><creatorcontrib>Connolly, Heidi M., MD</creatorcontrib><creatorcontrib>Warnes, Carole A., MD</creatorcontrib><creatorcontrib>Puga, Francisco J., MD</creatorcontrib><title>Intermediate-term results of ascending–descending posterior pericardial bypass of complex aortic coarctation</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aorta, Thoracic - surgery</subject><subject>Aortic Coarctation - complications</subject><subject>Aortic Coarctation - surgery</subject><subject>Aortography</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Cardiovascular Surgical Procedures - methods</subject><subject>Diseases of the aorta</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - etiology</subject><subject>Hypertension - surgery</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Sternum - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Treatment Outcome</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks2K1UAQhYMoznX0CQTJRnGTWNV987dQkMGfgQEXKrhrOp3KTMe-6didjN6d7-Ab-iRW5l4ZcOOquuE7p4pTlSSPEXIELF8M-TCb65gLgDJHzAHxTrJBaKqsrIsvd5MNgBBZIYQ8SR7EOABABdjcT06wKqRotvUmGc_HmcKOOqtnytZnGigubo6p71MdDY2dHS9___zV0d9POvnIpPUhnbgYHVjt0nY_6XgjM343OfqRah9ma_irg5n1bP34MLnXaxfp0bGeJp_fvvl09j67-PDu_Oz1RWaKupwzbfqmrtqKqKK-ayQ2ULeiNFQjGhRUdI1psOvKbQVF3UnZVGDANJ3BopWilKfJs4PvFPy3heKsdpbHd06P5JeoWFZs2ZdBeQBN8DEG6tUU7E6HvUJQa8xqUDcxqzVmhag4ZlY9OdovLWd3qznmysDTI8ARatcHPRobb7m6FhJQMPf8wF3Zy6vvNpCKO-0c2-LaNqKUirsWsGX05QElzu3aUlDRWBoNry6QmVXn7X9mfvWP3jg78vbcV9pTHPwSRl6JQhWFAvVxPZ71dqAEgaKW8g9JzcKD</recordid><startdate>20070601</startdate><enddate>20070601</enddate><creator>McKellar, Stephen H., MD</creator><creator>Schaff, Hartzell V., MD</creator><creator>Dearani, Joseph A., MD</creator><creator>Daly, Richard C., MD</creator><creator>Mullany, Charles J., MBMS</creator><creator>Orszulak, Thomas A., MD</creator><creator>Sundt, Thoralf M., MD</creator><creator>Connolly, Heidi M., MD</creator><creator>Warnes, Carole A., MD</creator><creator>Puga, Francisco J., MD</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070601</creationdate><title>Intermediate-term results of ascending–descending posterior pericardial bypass of complex aortic coarctation</title><author>McKellar, Stephen H., MD ; Schaff, Hartzell V., MD ; Dearani, Joseph A., MD ; Daly, Richard C., MD ; Mullany, Charles J., MBMS ; Orszulak, Thomas A., MD ; Sundt, Thoralf M., MD ; Connolly, Heidi M., MD ; Warnes, Carole A., MD ; Puga, Francisco J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c586t-acf987b7ee7efd931908b26ce811c12e5d9c91dd647058d33970c0c9dc15b3263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aorta, Thoracic - surgery</topic><topic>Aortic Coarctation - complications</topic><topic>Aortic Coarctation - surgery</topic><topic>Aortography</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Cardiovascular Surgical Procedures - methods</topic><topic>Diseases of the aorta</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - etiology</topic><topic>Hypertension - surgery</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Sternum - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McKellar, Stephen H., MD</creatorcontrib><creatorcontrib>Schaff, Hartzell V., MD</creatorcontrib><creatorcontrib>Dearani, Joseph A., MD</creatorcontrib><creatorcontrib>Daly, Richard C., MD</creatorcontrib><creatorcontrib>Mullany, Charles J., MBMS</creatorcontrib><creatorcontrib>Orszulak, Thomas A., MD</creatorcontrib><creatorcontrib>Sundt, Thoralf M., MD</creatorcontrib><creatorcontrib>Connolly, Heidi M., MD</creatorcontrib><creatorcontrib>Warnes, Carole A., MD</creatorcontrib><creatorcontrib>Puga, Francisco J., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McKellar, Stephen H., MD</au><au>Schaff, Hartzell V., MD</au><au>Dearani, Joseph A., MD</au><au>Daly, Richard C., MD</au><au>Mullany, Charles J., MBMS</au><au>Orszulak, Thomas A., MD</au><au>Sundt, Thoralf M., MD</au><au>Connolly, Heidi M., MD</au><au>Warnes, Carole A., MD</au><au>Puga, Francisco J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intermediate-term results of ascending–descending posterior pericardial bypass of complex aortic coarctation</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2007-06-01</date><risdate>2007</risdate><volume>133</volume><issue>6</issue><spage>1504</spage><epage>1509</epage><pages>1504-1509</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>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.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>17532948</pmid><doi>10.1016/j.jtcvs.2006.11.011</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aorta, Thoracic - surgery Aortic Coarctation - complications Aortic Coarctation - surgery Aortography Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiothoracic Surgery Cardiovascular Surgical Procedures - methods Diseases of the aorta Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Humans Hypertension - etiology Hypertension - surgery Magnetic Resonance Angiography Male Medical sciences Middle Aged Recurrence Retrospective Studies Sternum - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Treatment Outcome |
| title | Intermediate-term results of ascending–descending posterior pericardial bypass of complex aortic coarctation |
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