Axillo-iliac artery bypass for recurrent aortic coarctation to reduce cardiac afterload

Interact Cardiovasc Thorac Surg. 2018 Oct 1;27(4):626-628. doi: 10.1093/icvts/ivy115.

Abstract

A 13-year-old girl, who had undergone interrupted aortic arch repair with an 8-mm graft as a neonate and Fontan completion in childhood, developed ventricular fibrillation due to long-QT syndrome. Cardioverter defibrillator implantation was planned. Preoperative catheterization showed a 45-mmHg aortic pressure gradient and ventricular end-diastolic pressure of 11 mmHg. This indicated that recurrent coarctation had adversely affected ventricular function. After consideration of the patient's age, symptoms and anatomical/surgical complexities, axillo-iliac bypass with cardioverter defibrillator implantation was performed. Postoperative ventricular end-diastolic pressure was 6 mmHg. Axillo-iliac bypass is a surgical option for coarctation that can reduce cardiac afterload.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anastomosis, Surgical
  • Aortic Coarctation / diagnosis
  • Aortic Coarctation / physiopathology
  • Aortic Coarctation / surgery*
  • Axillary Artery / surgery*
  • Female
  • Heart
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / physiopathology
  • Humans
  • Iliac Artery / surgery*
  • Plastic Surgery Procedures / methods*
  • Recurrence
  • Vascular Surgical Procedures / methods*
  • Ventricular Function, Left / physiology*
  • Ventricular Pressure / physiology*