Results of using cardiopulmonary bypass for spinal cord protection during surgical repair of complex aortic coarctation

Abstract

Complex aortic coarctation without hypoplasia of the proximal aortic arch and intra-cardiac anomalies can be repaired with low mortality and neurologic morbidity via a left thoracotomy using cardiopulmonary bypass. The use of cardiopulmonary bypass goes along with a low risk of spinal cord and lower body ischaemia and provides a sufficient amount of time for the anastomoses.

Right aortic arch with an aberrant left subclavian artery and aortic coarctation including a descending aortic aneurysm

“…Partial CPB appears as a convenient and practical method for this type of surgical treatment. Moreover, application of partial CPB goes along with a low risk of spinal and lower body ischemia and provides enough time for anastomoses [6]. Nakamura et al presented three CoA cases with usage of partial CPB during the surgery.…”

Selection of a Surgical Treatment Approach for Aortic Coarctation in Adolescents and Adults

“…1 because intraoperative femoral blood pressure was 65 mmHg. 11) CoA resection with interposition graft as described by Gross was performed via lateral thoracotomy. 12) This procedure is recommended particularly in cases of longsegment CoA and CoA with aneurysm formation.…”

Surgical Treatment of Thoracic Aortic Aneurysms in Patients with Congenital Heart Disease

“…Recently, endovascular management of descending aortic aneurysms has emerged as an evolving technology, and it has been applied for pseudoaneurysms after previous surgical repair of coarctation. [20][21][22] Stent graft therapy has some advantages over surgical treatment, such as granting less invasive access to the target lesion, resulting in shorter hospital stays, and minimal pain for the patient. Endovascular stent therapy may become the preferred option for this lesion in the near future.…”