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At least 19 recordsLinked to original sources
PubMed1977

Ascending aorta-abdominal aorta bypass: indications, technique, and report of 12 patients.

Use of the supraceliac segment of the abdominal aorta for ascending aorta-abdominal aorta bypass (AAAAB) offers a new technique for management of certain difficult surgical problems. Since 1973, we have performed AAAAB in 12 patients: 4 with recurrent coarctation of the thoracic aorta; 4 with coarctation of the thoracic aorta and associated cardiac lesions requiring a concomitant intracardiac procedure; 2 with recurrent aortoiliac occlusive disease (AIOD); 1 with interruption of the aortic arch requiring concomitant pulmonary artery banding; and 1 with coarctation of the abdominal aorta. In 3 of these patients (2 with recurrent AIOD and 1 with coarctation of the abdominal aorta) the distal anastomosis was made to the distal abdominal aorta or femoral arteries. Ten patients (83.3%) experienced satisfactory results; 2 patients (16.6%) died. The technique of AAAAB provides a practical solution to complex situations in which previous procedures preclude a standard operative approach, or when necessary concomitant procedures would otherwise require a two-stage operation.

Adolescent↗
PubMed1977

Staphylococcal aortic pseudoaneurysm. Treatment employing ascending aorta-abdominal aorta bypass graft.

An adult patient developed infection of the anastomosis after resection of an isthmic coarctation, with subsequent formation of a pseudoaneurysm. He was treated successfully by an ascending aorta-abdominal aorta bypass graft. The graft was placed retrosternally and passed through the diaphragm into the retroperitoneal space. After surgery the patient developed systolic hypertension. A faint murmur was heard over the chest and abdomen, caused by the turbulent flow through the graft.

Adult↗
PubMed1981

[Decompensated valvular disease and coarctation. One-stage repair using a median approach with an ascending aorta-abdominal aorta shunt].

The tactical decision in patients with decompensated valvular disease associated with a severe stenosis of the aortic isthmus is always difficult. One stage surgical repair using two separate approaches is a long and high risk procedure. It would seem more logical and safer to treat the lesions in two stages a few weeks apart, the severest lesion being managed first. In the two cases reported. The isthmic stenoses and valvular lesions were of the same severity and made both classical techniques impracticable. Therefore the patients underwent a single stage procedure by a median approach associating valve replacement under cardiopulmonary bypass (mitral and tricuspid in one and aortic in the other case) and an ascending aorta-abdominal aorta dacron conduit. The present postoperative survival periods are 30 and 9 months. The functional result was good (Class 1 and 0) and postoperative angiography has shown the montage to be working satisfactorily. This technique is exceptional but may be useful in borderline cases with decompensated valvular disease and severe isthmic stenosis.

Aorta↗
PubMed2003

Ascending aorta-abdominal aorta bypass for Takayasu's arteritis.

Three patients with type III Takayasu's arteritis were referred to us because of the upper extremity hypertension and vascular claudication of the lower extremities. They underwent extra-anatomic ascending aorta-abdominal aorta bypass with vascular graft under a median sternotomy and a splitted midline laparotomy incision without cardiopulmonary bypass. The postoperative course was uneventful. Upper extremity hypertension and vascular claudication were completely resolved.

Aorta↗
PubMed2002

Surgical treatment for primary infected aneurysm of the descending thoracic aorta, abdominal aorta, and iliac arteries.

OBJECTIVE AND METHOD: In this retrospective review, we report the surgical results of infected aortic aneurysms treated at a single center over 5 years. RESULTS: From October 1996 to October 2001, 19 patients with infected aortic aneurysm were treated with surgery, nine with suprarenal infections (four proximal descending thoracic aortic aneurysms, two distal descending thoracic aortic aneurysms, and three suprarenal abdominal aortic aneurysms) and 10 with infrarenal infections (eight infrarenal abdominal aortic aneurysms and two iliac artery aneurysms). All had a positive blood or tissue culture; 89% were febrile, 89% had leukocytosis, and 32% were hemodynamically unstable. The most common responsible pathogens were Salmonella organisms (74%) followed by Streptococcus species (11%). Nine of 10 infrarenal infections were caused by Salmonella organisms. Both infrarenal and suprarenal infections were treated with wide débridement of infected aorta, in situ prosthetic graft or patch repair, and prolonged intravenous antibiotics. Hospital survival rate was 95%: 100% for infrarenal and 89% for suprarenal infections. There was no perioperative intestinal ischemia or perioperative limb loss. Acute renal failure occurred in two patients with suprarenal infection. Late deaths have occurred in three patients with one early graft infection (5%) resulting in the only one in-hospital death at 4 months. Sixteen patients remain alive at mean follow-up of 17.8 months (range, 4-47 months). There have been no late aortic or graft infections. During the same period, there were five unoperated patients, four of whom died of shock during hospitalization. CONCLUSIONS: Infected aortic aneurysm is common in Taiwan, and Salmonella species were the most common responsible microorganisms. With surgical intervention and prolonged intravenous antibiotics, in situ graft replacement provided a good outcome. The incidence of prosthetic graft infection was low, even in patients with infections due to Salmonella species and with in situ graft replacement.

Aged↗
PubMed1999

Two-stage operation for multiple aneurysms of the thoracic aorta, abdominal aorta, and left common iliac artery in an octogenarian.

Multiple aortic aneurysms are well described in the surgical literature. However, there are many problems related to surgical treatment of elderly patients with such aneurysms. This report presents the case, an octogenarian with multiple aortic aneurysms that were successfully treated by graft replacement. An 82-year-old man with a descending aortic aneurysm was referred to our institution for surgery. In addition to the previously diagnosed aneurysm, computed tomography and aortography showed an abdominal aortic aneurysm and a left common iliac aneurysm. Since the patient was an elderly man with chronic obstructive pulmonary disease, a two-stage operation was performed. The abdominal aortic aneurysm and left common iliac aneurysm were resected first due to the risk of thromboembolism from the abdominal aortic aneurysm during surgery involving replacement of the descending aorta under femoro-femoral (F-F) bypass. Fifty-two days after the first operation, a second operation was performed to repair the descending aortic aneurysm. The postoperative course was uneventful. Angiography after the operation showed satisfactory replacement of the multiple aortic aneurysms. The patient was discharged 25 days after the second operation.

Aged↗
PubMedDate not supplied

[Ascending thoracic aorta-supraceliac abdominal aorta by-pass in a patient with coarctation and partial hypoplasia of the arch and aortic isthmus].

A twenty years old patient, with arterial hypertension at the right arm and absent pulse in both lower extremities was studied by angiography, and a coarctation of aortic arch with partial hypoplasia of aortic arch and aortic isthmus was found. Patient underwent to a surgical operation and, by anterior approach, an ascending thoracic aorta-supraceliac abdominal aorta by-pass was made. In the present case report, advantages, indications and experience with such by-pass modality are review.

Adult↗
PubMed2004

[One-staged operation for multiple aortic aneurysms of the descending thoracic aorta and abdominal aorta; report of a case].

A 66-year-old man underwent successfully on one-staged operation for aneurysms of the descending thoracic aorta and abdominal aorta. For the operation of descending thoracic aortic aneurysm, a temporary bypass was used from the proximal side of aneurysm to the distal one. The sacculer aneurismal wall of the descending thoracic aorta was repaired by patch formation using a knitted graft. Abdominal aortic aneurysm was replaced using a Gelsoft graft. The operation time was 7 hours and 35 minutes. Blood transfusion was not needed. The postoperative course was uneventful. It is suggested that one-staged operation for descending thoracic aortic aneurysm under the assist of temporary bypass and abdominal aortic aneurysm is possible.

Aged↗
PubMed1979

Ascending aorta-supraceliac abdominal aorta bypass: successful removal of an infected graft in the descending thoracic aorta.

An infected graft and a mycotic pseudoaneurysm were successfully resected by employing an ascending aortasupraceliac abdominal aorta bypass graft in a 19-year-old man. He had formerly undergone graft replacement surgery for traumatic aneurysm of the descending thoracic aorta, with the aid of a temporary external bypass graft. After this first operation, the patient had suffered from septicemia due to Psudomonas aeruginosa, which resulted in formation of mycotic pseudoaneurysms at the distal anastomotic site of the prosthetic graft and at both stumps of the formerly employed external bypass graft.

Adult↗
PubMed1991

[Acquired aneurysms of the infrarenal abdominal aorta].

Abdominal aortic aneurysms (AAA) are the result of a degenerative process of the aortic wall. The incidence of AAA has increased during the last three decades. Computerized axial tomography is the best method for investigating AAA. For aneurysms of 4-5 cm or more in antero-posterior diameter, the risk of rupture is definitely high and justifies a preventive surgery. Precise evaluation of myocardial function and of coronary circulation may limit the operative risk and may improve the life expectancy. Screening of AAA in populations at risk will allow to survey the natural history of aneurysmal disease and limit the incidence of rupture which keeps a high mortality rate.

Age Factors↗
PubMed1994

[Effect of dopexamine in splanchnic perfusion during surgery of the abdominal aorta].

Abdominal aortic surgery has significant effects on cardiac and splanchnic perfusion. The purpose of this study was to examine the effects of dopexamine, an inodilator drug, on hemodynamic and splanchnic perfusion with measurement of gastric intramucosal pH, by the method of gastric tonometry, during abdominal aneurysm resection. Twenty-five patients undergoing excision of an aortic abdominal aneurysm were randomly divided into two groups. During aortic cross-clamping Group II patients received dopexamine infusion, at a dose of 1 microgram/kg/m, and at a dose of 0.5 micrograms/kg/m from declamping to the end of the surgery. Whereas Group I patients did not receive a dopexamine infusion. During aortic cross-clamping the intramucosal pH value decreased in Group I patients, but did not change in Group II patients. Heart rate, cardiac index, and mixed venous oxygen saturation increased significantly during dopexamine infusion, whereas systemic vascular resistance was reduced. During aortic cross-clamping dopexamine was a useful agent in improving splanchnic blood flow, cardiac index venous saturation. Also, since the drug produces dose related hemodynamic changes of rapid onset and reversibility, it is possible to interrupt the infusion before aortic declamping to avoid the decrease in the intramucosal pH value.

Aged↗
PubMed1992

[Interposition of a prosthetic graft between the ascending aorta and the abdominal aorta in the treatment of complicated or longstanding coarctations in adults].

Although the direct approach to the aortic isthmus is unquestionable for an isolated coarctation of the thoracic aorta, recurrent coarctations of coarctation with associated cardiac lesions require a concomitant procedure, raise difficult surgical problems and expose to a high operative risk. Another technique consists of performing an ascending aorta-abdominal aorta by-pass, with a prosthetic tube. From 1977 to 1988, this technique was performed in 8 patients: 3 with recurrent coarctations, 4 with coarctation associated with a surgical aortic insufficiency (2 ascending aortic aneurysms with aortic insufficiency) and 1 with abdominal aorta coarctation. The mean age was 48.3 years (range from 31 to 72 years), the mean follow-up was 44.3 months (range from 4 months to 10 years 5 months). There was no mortality and no morbidity during the follow-up. The functional result is good, without high blood pressure and with no blood pressure difference between the arms and the legs. Postoperative angiographies showed that all the by-passed were patent.

Adult↗
PubMed1991

Arteriopathy and coarctation of the abdominal aorta in children with mucopolysaccharidosis: imaging findings.

Eight children with mucopolysaccharidosis I (MPS I), representing 33% of all children with MPS I seen at our institution during an 18-year period, developed hypertension. Five of these hypertensive children also exhibited symptoms of aortic coarctation. The radiographic evaluation of four of these children with MPS I (three with Hurler syndrome, MPS I H, and one with Scheie disease, MPS I S) and arteriopathy affecting the thoracic aorta, abdominal aorta, and visceral and renal arteries is presented. Hypertension developed in all four children before they were 4 years old; three had differences between upper- and lower-extremity blood pressures. Irregular narrowing of the abdominal aorta with either multiple minor asymmetric wall lesions (n = 2) or abrupt concentric narrowing (n = 2) was present in all children as shown by aortography (n = 3), sonography (n = 3), MR imaging (n = 2), and/or autopsy (n = 1). A variety of other vessels also were involved, including the ascending aorta (n = 1) and vertebral (n = 1), axillary (n = 1), intercostal (n = 2), lumbar (n = 2), mesenteric (n = 3), renal (n = 2), and iliac arteries (n = 3). Autopsy in one child demonstrated thickened heart valves, narrowing of the coronary arteries, and irregularity of the aorta due to deposition of mucopolysaccharide material within the intima. Our series demonstrates various facets of the arteriopathy of MPS I as shown by sonography, MR imaging, and angiography.

Angiography↗