Single-Stage Repair of a Critical Aortic Coarctation, a Bicuspid Aortic Stenosis and an Ascending Aortic Aneurysm

Abstract

We report a 26-year-old man with critical aortic coarctation, severe bicuspid aortic valve stenosis, infective endocarditis and ascending aortic aneurysm. He underwent simultaneously in singlestage a Bentall's procedure and an extra-anatomic ascending-descending aortic bypass grafting by 14-mm Dacron tube, through median sternotomy. The immediate postoperative outcome was favourable. The CT scan control for 7 years after surgery showed a good patency of the extra-anatomic bypass.

A single stage approach to ascending aortic aneurysm and coarctation: Feasibility and challenges

“…The combination of aortic coarctation and ascending aortic aneurysm with aortic valve disease is not an uncommon entity. Therapeutic strategies that have been proposed for the correction of this combined entity include: catheter‐based intervention by percutaneous dilatation‐stenting of the coarctation, followed by surgical repair of the aortic valve and the aortic root by median sternotomy, a double‐stage procedure using sternotomy for (aortic valve and aortic root disease) and thoracotomy (for coarctation repair), and finally a single‐stage repair of all pathologies by median sternotomy . Surgical correction of the aortic coarctation with thoracotomy in adults is faced with many challenges including extensive dissection to control the aorta and the collateral blood vessels with the risk of significant hemorrhage, pulmonary injuries, recurrent laryngeal or phrenic nerves damage, chylothorax and spinal cord ischemia and paraplegia.…”