One-stage ascending-to-abdominal aortic bypass with concomitant aortic valve procedures for aortic coarctation combined with aortic valve pathology in adult patients.

ABSTRACT

OBJECTIVE: This study aims to evaluate the results of one-stage ascending-to-abdominal aortic bypass and aortic valve replacement for concomitant aortic coarctation combined with aortic valve pathology. METHODS: From June 2009 to March 2017, 28 consecutive adult patients (23 males and five females) with aortic coarctation combined with aortic valve pathology underwent one-stage ascending-to-abdominal aorta bypass and aortic valve replacement or a Bentall procedure. Patients were followed for a mean of 45.5 ± 26.5 months (range 3-96 months). RESULT: All patients successfully underwent the one-stage procedure. No early deaths were recorded. The mean aortic cross-clamp and cardiopulmonary bypass times were 71 ± 23 and 113 ± 37 mins, respectively. Re-exploration for bleeding was performed on one patient (3.6%). The average post-operative hospital stay was 15.9 ± 4.9 days and the average operation time was 5.2 h. No paraplegia or stroke was observed. The blood pressure gradient of the upper and lower extremities significantly decreased (P < 0.001). Systolic blood pressure decreased from 158 ± 36 mmHg pre-operatively to 121 ± 18 mmHg post-operatively. No deaths or significant gradients between the upper and lower extremities occurred during follow-up. No death and complications of bypass grafts occurred during follow-up. CONCLUSION: Ascending-to-abdominal aortic bypass and concomitant aortic valve procedures are a suitable therapeutic option for severe aortic coarctation combined with aortic valve pathology in adult patients.