Ascending-to-Abdominal Aortic Bypass Grafting in a Case of Middle Aortic Syndrome

Daisuke Iwahashi＊	Yuki Ikegaya＊	Nao Kume＊
Shoichi Tsuda＊	Tatsuya Nakao＊

（Department of Cardiovascular Surgery, New Tokyo Hospital＊, Matsudo, Japan）

Symptomatic aortic stenosis in adults causes complications such as secondary hypertension, heart failure, abdominal organ perfusion failure, and lower limb ischemia;therefore, medical management is difficult. Although there are reports of endovascular treatment using a catheter and surgery as treatment methods, there is no consensus on the treatment strategy. An 82-year-old woman was admitted to our hospital because of high blood pressure and heart failure. She underwent ascending-to-abdominal aortic bypass grafting with cardiopulmonary bypass. Proximal anastomosis was established during cardiac arrest. We performed the anti-anatomical anastomotic procedure using a large artificial graft, which was guided directly from the posterior pericardium to the retroperitoneal cavity. Although the surgery was highly invasive, the patient exhibited a favorable outcome. We report this case because the treatment method may be useful as one of the curative treatments for middle aortic syndrome.

 

Jpn. J. Cardiovasc. Surg. 50:137-141（2021）

Keywords：middle aortic syndrome（MAS）;adult aortic coarctation;surgical treatment