Aortic valvular insufficiency and postductal aortic coarctation in the adult

Posterior Pericardial Ascending-to-Descending Aortic Bypass Through Median Sternotomy

“…4 In 1980, Vijayanagar et al described an adult patient with coarctation of the aorta and severe aortic valve regurgitation. 5 Ascending aorta-to-descending aorta bypass was performed by exposing the descending thoracic aorta through the posterior pericardium and placing the graft around the left margin of the heart. The proximal anastomosis was made to the left lateral aspect of the ascending aorta.…”

“…The latter is usually associated with morbidity of two incisions and hemodynamic derangements, possible following repair of either only cardiac defect or the coarctation 4 . In 1980, Vijayanagar et al described an adult patient with coarctation of the aorta and severe aortic valve regurgitation 5 . Ascending aorta‐to‐descending aorta bypass was performed by exposing the descending thoracic aorta through the posterior pericardium and placing the graft around the left margin of the heart.…”

“…Exposure of the descending thoracic aorta through a median sternotomy and the posterior pericardium was described by Vijayanagar et al and subsequently modified by others, whose alternate approach permits simultaneous intracardiac repair when necessary. 5,6…”

“…Various techniques of extra‐anatomic bypass grafting from the ascending aorta have been described, including methods in which the distal anastomosis is performed on the descending thoracic aorta, the supraceliac abdominal aorta, or the infrarenal abdominal aorta. Exposure of the descending thoracic aorta through a median sternotomy and the posterior pericardium was described by Vijayanagar et al and subsequently modified by others, whose alternate approach permits simultaneous intracardiac repair when necessary 5,6 …”

Ascending-to-Descending Aortic Bypass via Posterior Pericardium for Complex Coarctation of Aorta

“…Recurrent aortic coarctation, or coarctation associated with intracardiac abnormalities, is known as “complex coarctation,” which may be difficult to manage by traditional approach, especially in children and adult patients. In 1980, Vijayanagar 1 first reported the procedure to perform the ascending‐to‐descending bypass graft via median sternotomy to treat such patients. From September 2004 to April 2005, four patients diagnosed of “complex coarctation” underwent extraanastomical bypass graft operation in our institute with satisfied result.…”