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Experience in one stage repair and step-by-step operations of an ascending aortic aneurysm and aortic coarctation

Bakoulev Scientific Center of Cardiovascular Surgery, 135 Roublevskoe Shosse, 121552 Moscow, Russia

One-stage repair of an aortic dissection and aortic coarctation

We would like to congratulate the authors on the interesting operation and positive outcome on such a high-risk patient [1]. The publication presents a crucial issue of contemporary cardiovascular surgery, the issue which currently lacks a definitive solution – the life-threatening pathology of ascending aorta associated with aortic coarctation. The isolated correction of dissection or coarctation results in acute cardiac failure whereas the one-stage repair is highly traumatic and is aggressive itself. Over the last ten years between 1996 and 2006, in our Center, the surgical repair of ascending aortic aneurysm associated with aortic coarctation was performed on more than 50 patients. In 15 cases one-stage repair was performed and 37 patients were subjected to step-by-step operations (the first stage procedure was in 32 cases – the correction of aortic coarctation and in five patients – the ascending aortic aneurysm repair). The main indications of one-stage repair were large-sized ascending aortic aneurysms, significant aortic valve insufficiency, a systolic arterial pressure gradient in the zone of coarctation exceeding 45 mmHg and coexisting systemic hypertension resistant to medical therapy. We observed 7.6% mortality that we believe is acceptable in this severe pathology (two patients died after one-stage repair and two deaths followed step-by-step procedures). Finally, we once again congratulate the authors on their good results and hope to present our own experience on this problem in the near future.

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1. Cranfield KR, Brackenbury ET, Fraser SCA. One-stage repair of an aortic dissection and aortic coarctation. Interact CardioVasc Thorac Surg 2008; 7:170–172.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. Articles by Arakelyan, V. Search for Related Content PubMed Articles by Bockeria, L. Articles by Arakelyan, V. Related Collections Related Article