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Korean J Thorac Cardiovasc Surg. 2017 Aug;50(4):270-274. doi: 10.5090/kjtcs.2017.50.4.270. Epub 2017 Aug 5.

Extra-Anatomic Ascending Aorta to Abdominal Aorta Bypass in Takayasu Arteritis Patients with Mid-Aortic Syndrome.

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1
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine.

Abstract

BACKGROUND:

We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome.

METHODS:

From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was 43.5±12.2 years and the mean peak pressure gradient between the upper and lower extremities was 54.8±39.0 mm Hg. The median follow-up duration was 54.4 months (range, 17.8 to 177.4 months).

RESULTS:

There were no cases of operative mortality. The mean peak pressure gradient significantly decreased to -2.4±32.3 mm Hg (p=0.017 compared to the preoperative value). Late death occurred in 2 patients. The symptoms of upper extremity hypertension and claudication improved in all patients. The bypass grafts were patent at 47.1±58.9 months in 7 patients who underwent follow-up imaging studies.

CONCLUSION:

An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.

KEYWORDS:

Extra-anatomic bypass; Mid-aortic syndrome; Takayasu arteritis

Conflict of interest statement

Conflict of interest No potential conflicts of interest relevant to this article are reported.

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