| Axillo-Iliac Bypass
in a Child with Relative Graft Stenosis Following Reconstructive
Repair of Interrupted Aortic Arch Type A |
(Division of Cardiovascular Surgery, Chiba Cardiovascular
Center, Ichihara, Japan)
| Seiichi Yamaguchi |
Hirokazu Murayama |
Naoki Hayashida |
| Kozo Matsuo |
Atsushi Hata |
Soichi Asano |
| Hiroyuki Watanabe |
Yasutsugu Nakagawa |
Katsuhiko Tatsuno |
|
A 12-year-old girl had relative
graft stenosis following the reconstruction of type A interrupted
aortic arch. At 25 days after birth she underwent ascending aorta-descending
aorta bypass with a 7mm knitted Dacron graft, ligation of the
patent ductus arteriosus and pulmonary artery banding. She had
patch closure of a ventricular septal defect (VSD) as well at
20 months of age. At age 12 catheterization was carried out,
because she had headache and dizziness on exertion. The pressure
of the ascending aorta was 163/79mmHg and the pressure gradient
between the ascending and the descending aorta was 65mmHg. Aortography
revealed severe stenosis of the graft, which might have occurred
according to her growth. An extra-anatomic bypass was placed
between the right axillary and the right common iliac artery
through the intrapleural and preperitoneal route with a 10mm
Dacron graft. Six months later, the blood pressure was 108/63mmHg
in the upper extremities, the pressure gradient between the upper
and lower extremities was reduced to 18mmHg, and headache and
dizziness had disappeared.
Jpn. J. Cardiovasc. Surg. 29: 187-190 (2000) |
|
