Isolated supradiaphragmatic descending thoracic aorta stenosis in a Takayasu's disease: surgical cure

Segers, Bernard; Derluyn, M.; Barroy, Jean-Paul; Brunet, A

doi:10.1016/s1010-7940(01)01012-0

Cited by 7 publications

(10 citation statements)

References 10 publications

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“…Obstructive lesions or hypoplasia of the descending aorta is a rare vascular anomaly 1,2,4. The term middle aortic syndrome (MAS) describes the clinico-anatomical entity of the aorta, irrespective of its aetiology and pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…Another hypothesis implicates intra-uterine injury or infection, particularly by Rubella virus, as a risk factor that may precipitate aortic hypoplasia. Acquired MAS is associated with neurofibromatosis, William’s syndrome, Alagille syndrome, fibromuscular dysplasia, retroperitoneal fibrosis (Ormond disease), mucopolysaccharidosis, foetal alcohol syndrome and Takayasu arteritis 1-4…”

Section: Discussionmentioning

confidence: 99%

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Successful surgical treatment of a subtotal descending aortic occlusion

Puślecki

Perek

Stefaniak

et al. 2017

CVJA

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful surgical treatment of a subtotal descending aortic occlusion

Puślecki

Perek

Stefaniak

et al. 2017

CVJA

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“…[1][2][3] The aortic narrowing located in the descending thoracic aorta, abdominal aorta, or both is called "middle aortic syndrome" by Sen et al 4 Etiology of this vascular disease is not well known. Congenital, inflammation, developmental disorder, and infection are thought to be some of the causes.…”

Section: Discussionmentioning

confidence: 99%

Ascending to Descending Aorta Bypass for Middle Aortic Syndrome

Uwabe

Okada

Harada

2007

Circ J

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iddle aortic syndrome is rare vascular anomaly, which involves long segment narrowing of the descending thoracic and abdominal aorta. The most common clinical manifestation is severe uncontrolled hypertension. We present a successful re-operation by the ascending to descending aorta bypass for middle aortic syndrome patient. Case ReportA 52-year-old woman complained of headache and easy fatigability of the lower extremities and had poorly controlled high blood pressure. Both femoral pulses were present but weak. Her blood pressure was 180/120 mmHg in the brachial artery and 108/76 mmHg in the thigh. Routine laboratory data were normal, with a blood urea nitrogen level of 12 mg/dl and a creatinine level of 0.6 mg/dl. C-reactive protein was negative. Twenty-seven years previously, she had undergone bypass grafting for Takayasu aortitis at another hospital. According to the operation record, an 8-mm-diameter prosthetic tube graft was bypassed from the descending thoracic aorta to the infrarenal abdominal aorta and it was passed through the aortic hiatus through a left thoracotomy and midline laparotomy.In the present admission computed tomography scanning showed marked diffuse narrowing of the descending thoracic aorta with severe calcification (Fig 1). The diameter of the aorta was 21 mm at the distal arch, 6 mm at the diaphragm level, 11 mm at the superior mesenteric artery level and 20 mm at the aortic bifurcation. The supradiaphragmatic descending aorta was completely occluded. The prosthetic graft was also severely atherosclerotic, but pseudoaneurysm formation was not detected on either the graft itself or at both anastomoses. The ascending aorta was normal and the both internal thoracic arteries were dilated. The right kidney was atrophic and non-functional. Preoperative angiography revealed total occlusion of the aorta from the mid-descending thorax to proximal to the celiac artery and multiple stenoses of the bypass graft. Blood flow to the celiac artery, the superior mesenteric artery, and the left renal artery was supplied retrogradely by the stenotic bypass graft. The right renal artery was occluded. No abnormality was detected in the ascending aorta, aortic arch, or supracervical branches. These findings indicated that her symptoms were related to the multiple stenoses of the graft, in addition to small size of the bypass graft itself. We decided to replace the graft.The operation was performed through a midline sternotomy and pararectal retroperitoneal approach. The ascending aorta was side-clamped and a 16-mm-diameter prosthetic tube graft was anastomosed in an end-to-side fashion. The graft was passed through a small incision in the left lateral portion of the diaphragm. Adhesion of the former anastomosis, just distal to the left renal artery, was so dense that the distal end of the new graft was anastomosed at the aortic bifurcation, which appeared to be a normal part of the aortic wall. The patient's postoperative course was uneventful. Her hypertension was controlled without antihypertensive agent...

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“…Thrombosis, distal embolization (blue toe syndrome) and aortic dissection are potential risks of endovascular treatment [4][5][6][7]. 3.…”

Section: Case Presentationmentioning

confidence: 99%

“…Stenotic lesions lying within the aortic segments II-IV are defined either as 'atypical' coarctation or as 'middle aortic syndrome' [5]. Middle aortic syndrome with localized or diffuse stenosis of the inferior thoracic aorta or the abdominal aorta is an unusual cause of arterial hypertension in the upper extremities.…”

Section: Middle Aortic Syndromementioning

confidence: 99%

Emergent thoracic aortic angioplasty and stenting for middle aortic syndrome in non-specific aortitis

Fujino

Mabuchi

Yoshida

et al. 2010

Cardiovasc Interv and Ther

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A 61-year-old Japanese male was admitted to hospital due to severe congestive heart failure and pre-renal failure with middle aortic syndrome. The patient was successfully treated with emergent aortic angioplasty and kissing stents implantation whilst in a hemodynamically unstable state. Our experience confirms that stenosis of the descending aorta when treated with catheter intervention may be palliative, however, it was a very effective method for life threatening clinical conditions in the short and mid-term and may be an alternative to surgery.

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Isolated supradiaphragmatic descending thoracic aorta stenosis in a Takayasu's disease: surgical cure

Cited by 7 publications

References 10 publications

Successful surgical treatment of a subtotal descending aortic occlusion

Successful surgical treatment of a subtotal descending aortic occlusion

Ascending to Descending Aorta Bypass for Middle Aortic Syndrome

Emergent thoracic aortic angioplasty and stenting for middle aortic syndrome in non-specific aortitis

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