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

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

• Kim HJ
• Choi JW
• Hwang HY
• Ahn H

• KMID: 2387913
• DOI: http://doi.org/10.5090/kjtcs.2017.50.4.270

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.

Keyword

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

MeSH Terms

Aorta*
Aorta, Abdominal*
Follow-Up Studies
Humans
Hypertension
Lower Extremity
Mortality
Takayasu Arteritis*
Transplants
Upper Extremity