One-stage repair of aortic coarctation and cardiac pathology via sternotomy

Abstract

Background Aortic coarctation is a hereditary disease often accompanied by ascending aortic aneurysm and aortic valve disease. We introduce a single-stage surgical treatment option for patients with aortic coarctation, ascending aortic aneurysm, and aortic valve disease, with a comparative analysis of the results. Methods The study included six patients with aortic coarctation, ascending aortic aneurysm, and aortic valve disease. All operations were performed by a full median sternotomy. For a comparative analysis, the patients were divided into two groups: 3 patients underwent ascending-to-descending aortic bypass, and the other 3 underwent surgical aortic coarctation repair. The short- and medium-term postoperative periods were monitored. The mean duration of monitoring was 27 months. Results When comparing the 2 groups, we observed a tendency for improvement in all intraoperative parameters in the 2nd group. There was no mortality in the postoperative hospital period. One (16.7%) patient died of stroke in the medium-term postoperative period. The other 5 patents showed no signs of procedure-related complications. Conclusion We recommend performing a single-stage procedure for surgical treatment of coarctation of the aorta with concomitant aneurysm of the ascending aorta and aortic valve disease. Compared to ascending-to-descending aortic bypass, surgical repair of aortic coarctation is more physiological, feasible via a sternotomy, and tends to improve intraoperative factors.