Caso 4/2007 - Coarctação de aorta: interposição de enxerto tubular na presença de aneurisma pós-endocardite

Croti, Ulisses Alexandre; Braile, Domingo Marcolino; Finoti, Renata Geron; Bonatto, Rossano César

doi:10.1590/s0102-76382007000200019

Cited by 1 publication

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“…Another important aspect refers to the risk of bleeding during the opening of the thorax and dissection of the structures adjacent to the aortic coarctation, due to the presence of large collaterals close to the aorta, as well as the superficial and intercostal muscular planes [13,14]. Additional care must be taken during the opening, performing accurate control of the blood pressure, due to the presence of HBP in the large majority of patients.…”

Section: Discussionmentioning

confidence: 99%

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Resultados do tratamento cirúrgico da coarctação de aorta em adultos

Jatene¹,

Abuchaim²,

Oliveira³

et al. 2009

Rev Bras Cir Cardiovasc

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Objective: The aim of this study is to describe our experience in aortic coarctation surgery in adult patients by assessing the immediate and mid-term outcomes.Methods: From January 1997 to March 2000, 50 consecutive adult patients underwent surgery for correction of aortic coarctation, through left lateral thoracotomy. Of these, forty two (84%) patients presented high blood pressure, with mean systolic arterial pressure of 170.56 mmHg (125-220 mmHg). The mean of pressure gradient in the coarctation area was 51.4 mmHg (18-123 mmHg). Other associated surgical cardiovascular diseases were not treated in the same operative act, except in two cases of patent ductus arteriosus (PDA). Three different techniques were used: aortic coarctation resection with end-to-end anastomosis was performed in 20 (40%) patients, coarctation enlargement with bovine pericardial patch was performed in 22 (44%) patients and synthetic tube interposition was performed in eight (16%) patients.Results: Operative morbidity was low; there was one case of bleeding who required reoperation. The most common immediate postoperative event was high blood pressure (98%), but it was easily controlled by intravenous drugs. There was no hospital death. Mean residual pressure gradient was 18.7 (8-33 mmHg). Patients were discharged in 9.5 days (5-30). Postoperative follow-up mean was 46.8 months (1-145 months) in 45 (91.8%) patients. Forty one (91.1%) of these followed-up patients had normal blood pressure, whereas 75.6% of them without drugs intake. 93.3% of these followed-up patients were asymptomatic. Four of them required further surgical operation, one needed a pacemaker implant, other two patients needed a cardiac valve replacement and one had endocarditis. There was one related death due to sepsis secondary to endocarditis.

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Section: Discussionmentioning

confidence: 99%

“…Several surgical techniques have been used in the correction of aortic coarctation in adults, such as resection and performance of end-to-end anastomosis, interposition of synthetic tubes or enlargement of the coarctate zone with varied patches [7][8][9][10][11][12][13][14].…”

Section: Jatene Mb Et Al -Outcomes Of Aortic Coarctation Surgical Trmentioning

confidence: 99%