One-stage repair for adults aortic coarctation concomitant with cardiac diseases: ascending aorta-abdominal aorta bypass combined with cardiac operation

Objective Evaluate the surgical result of ascending aorta-abdominal aorta bypass combined with cardiac operation for adults aortic coarctation concomitant with cardiac diseases. Methods Between February 2009 and September 2012, total 24 consecutive patients underwent ascending aorta- abdominal aorta bypass combined with cardiac operation. Of these patients, 2 patients who underwent off-pump coronary artery bypass grafting combined with ascending aorta-abdominal aorta bypass did not required cardiopulmonary bypass. Other 22 patients underwent one stage repair under cardiopulmonary bypass. The mean artery pressure of upper-lower limb was(38.0±9.34)mmHg. Results There was no in-hospital mortality. The mean artery pressure of upper-lower limb was(11.44±2.59)mmHg. The mean cardiopulmonary bypass time was(107.27±34.56) min. The mean aorta clamp time was(72.59±28.98)min. The mean intensive care unit stay time is(35.22±50.41)h. The mean mechanical ventilation time was(19.50±17.64)h. 2 patients required prolonged mechanical ventilation for respiratory dysfunction. Of these 2 patients, 1 patient required ECMO support for respiratory failure. Total 1 patient needed temporary continuous renal replacement therapy. No re-exploration for bleeding and gastrointestinal complications were observed. Aorta CTA scan was performed for all patients before discharged from hospital. The grafts were patent for all patients and no graft-related complications were observed. Conclusion Ascending aorta-abdominal aorta bypass combined with cardiac operation is a safe and effective one stage repair technique for adults aortic coarctation concomitant with cardiac diseases is a safe and effective technique.