Axillo-bilateral Iliac Artery Bypass for Atypical Coarctation of the Aorta with Severe Calcification

iDepartment of Cardiovascular Surgery, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japanj

Tsuyoshi Hachimaru Satoru Kawaguchi Masazumi Watanabe
Hideki Nakahara
A 66-year-old woman had hypertensive heart failure and intermittent claudication due to coarctation of the aorta with severe calcification. Consequently, axillo-bilateral iliac artery bypass was performed. Postoperatively, the difference in blood pressure between the upper and lower limbs decreased, the heart failure improved, and the intermittent claudication disappeared. The postoperative course was uneventful and the patient was discharged without complication 15 days after surgery. There are many case reports of aorto-aortic bypass for this disease;however, axillo-bilateral iliac artery bypass is an effective and less-invasive procedure. On the other hand, from the perspectives of long-term graft patency and abdominal visceral perfusion, careful postoperative follow-up of upper and lower limb blood pressure and renal perfusion is necessary.
  Jpn. J. Cardiovasc. Surg. 38:229-231i2009j