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One Stage Surgical Repair of Aortc Coarctation Existing with Ascending Aortic Aneurysm and Aortic Insufficiency
One Stage Surgical Repair of Aortc Coarctation Existing with Ascending Aortic Aneurysm and Aortic Insufficiency
Tayyar SARIOĞLU, Atıf AKÇEVİN, Bülent POLAT, Barbaros KINOĞLU, Mehmet Salih BİLAL, Servet ÖZTÜRK, Aydın AYTAÇ
İ.Ü. Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı
In Institute of Cardiology,.University of İstanbul, two patients who have ascending aortic
aneurysm and severe aortic insufficiency associated with aortic coarctation were operated on suc
cessfully with one-stage aproach. Patients (21 years old male and 22 years old female) have had
nearly same pathology, that is, severe aortic insufficiency with aneurysm of the ascending aorta
and aortic coarrtation (gradients in coractation site were 55 and 75 mmHg, respertively). First step
of the one-stage approach in both patients was correction of aortic coarctation with posterolateral
thoracotomy. Tlıis step was succeeded with bypass of aortic coarctation with a graft. After corree-
tion of aortic coarctation, thoracotomy was closed, patients were repositioned and median ster-
notomy was performed in the same stage.Cardiopulmonary bypass with moderate hypotlıermia
was started with the caıınulation of the aorta and rihgt atrium. Composite graft was implanted
after opening of the aneurysm and resection of aortic valves, and coronary ostia anastomozedto
the holles created on the appropriate site of the graft (Bentall operation). Both patients have had
uneventful postoperative course and were discharged on the tenth days of the operation with anti-
coagulant regimen. Tlıeir follow-up ranged from 16 months to 2 years have showed no consider-
able problem. This ııneventful follow-up (Both patients were in class l (NHYA) effort capacity)f
were confırmed postoperative angiocardiographic studies.
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