Extraanatomic aortic bypass for repair of aortic arch XXXX via sternotomy: midterm clinical and magnetic resonance imaging results.

@entity1 @entity101 @entity16 @entity11628 @entity1498 @entity299
BACKGROUND: We analyzed our 22 years of experience with extraanatomic bypass grafting for repair of aortic arch @entity1498 in adults. Results from early and midterm follow-up with clinical evaluation and magnetic resonance angiography are reported. METHODS: Between November 1979 and December 2001, 18 consecutive @entity1 aged 18 to 61 years (mean, 31.8 +/- 13.3 years) underwent extraanatomic bypass grafting to repair @entity1498 of the aortic arch. Six @entity1 (33.3%) had recoarctation after previous repair through a left thoracotomy, and 3 (16.7%) had associated @entity299 . The operative technique used in all @entity1 was ascending aorta-to-descending thoracic aorta bypass with a @entity11628 fiber (Dacron) graft through a median sternotomy and posterior pericardial approach. RESULTS: Follow-up was completed in all @entity1 , with a mean duration of 5.6 +/- 5.7 years (range, 12 months to 22 years). The follow-up interval exceeded 10 years in 5 @entity1 . No @entity16 , early or late mortality, late reoperations, or graft complications occurred. Six @entity1 (33.3%) had mild @entity101 . All @entity1 were asymptomatic with patent Dacron grafts confirmed by echocardiography. Magnetic resonance angiography, performed in 15 (83.3%) @entity1 , revealed that the Dacron grafts were still patent at a mean interval of 4.0 +/- 6.2 years (range, 5 days to 22 years) after repair. CONCLUSIONS: Extraanatomic ascending aorta-to-descending thoracic aorta bypass grafting for repair of aortic arch @entity1498 in adults is safe, with low morbidity and no mortality. The favorable midterm results indicate this technique is a safe and less invasive means of repairing aortic arch @entity1498 or recoarctation in adults.
