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Single Stage Repair for Aortic Coarctation associated with Intracardiac Defects Using Extra-Anatomic Bypass Graft in Adults.成人使用解剖外旁路移植术对合并心内缺损的主动脉缩窄进行一期修复
Korean Circ J. 2016 Jul;46(4):556-61. doi: 10.4070/kcj.2016.46.4.556. Epub 2016 Jul 21.
2
Repair of adult aortic coarctation by resection and interposition grafting.经切除及插入移植术修复成人主动脉缩窄
Interact Cardiovasc Thorac Surg. 2016 Oct;23(4):526-30. doi: 10.1093/icvts/ivw206. Epub 2016 Jun 26.
3
One stage surgical treatment of aortic valve disease and aortic coarctation with aortic bypass grafting through the diaphragm and aortic valve replacement.通过膈肌行主动脉旁路移植术并置换主动脉瓣，一期手术治疗主动脉瓣疾病和主动脉缩窄。
J Cardiothorac Surg. 2015 Nov 10;10:160. doi: 10.1186/s13019-015-0338-2.
4
Repair of primary or complicated aortic coarctation in the adult with cardiopulmonary bypass and hypothermic circulatory arrest.体外循环和低温循环阻断下修复成人原发性或复杂型主动脉缩窄。
J Thorac Cardiovasc Surg. 2015 Feb;149(2 Suppl):S83-5. doi: 10.1016/j.jtcvs.2014.07.071. Epub 2014 Aug 4.
5
Coarctation of the aorta - the current state of surgical and transcatheter therapies.主动脉缩窄——外科手术和经导管治疗的现状
Curr Cardiol Rev. 2013 Aug;9(3):211-9. doi: 10.2174/1573403x113099990032.
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Results of using cardiopulmonary bypass for spinal cord protection during surgical repair of complex aortic coarctation.在复杂主动脉缩窄手术修复过程中使用体外循环进行脊髓保护的结果。
Cardiol Young. 2014 Feb;24(1):113-9. doi: 10.1017/S1047951113000115. Epub 2013 Feb 6.
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Coarctation of the Aorta Stent Trial (COAST): study design and rationale.升主动脉支架置入试验（COAST）：研究设计和原理。
Am Heart J. 2012 Jul;164(1):7-13. doi: 10.1016/j.ahj.2012.04.008. Epub 2012 Jun 20.
8
Open, hybrid, and endovascular treatment for aortic coarctation and postrepair aneurysm in adolescents and adults.青少年和成人的主动脉缩窄及修复后动脉瘤的开放、杂交和血管内治疗。
Ann Thorac Surg. 2012 Sep;94(3):751-6; discussion 757-8. doi: 10.1016/j.athoracsur.2012.04.033. Epub 2012 Jun 16.
9
Stent placement versus surgery for coarctation of the thoracic aorta.胸主动脉缩窄的支架置入术与外科手术对比
Cochrane Database Syst Rev. 2012 May 16;2012(5):CD008204. doi: 10.1002/14651858.CD008204.pub2.
10
Long-term results of ascending aorta-abdominal aorta extra-anatomic bypass for recoarctation in adults with 27-year follow-up.成人再缩窄患者升主动脉-腹主动脉解剖外旁路移植术27年随访的长期结果
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青少年及成人主动脉缩窄手术治疗方法的选择

Selection of a Surgical Treatment Approach for Aortic Coarctation in Adolescents and Adults.

作者信息

Nakamura Eisaku, Nakamura Kunihide, Furukawa Koji, Ishii Hirohito, Kawagoe Katsuya

机构信息

Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki, Miyazaki, Miyazaki, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2018 Apr 20;24(2):97-102. doi: 10.5761/atcs.oa.17-00167. Epub 2018 Feb 16.

DOI:10.5761/atcs.oa.17-00167
PMID:29459569
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5930262/
Abstract

PURPOSE

Coarctation of the aorta (CoA) in adolescents and adults is relatively rare. Several operative techniques for CoA in adolescents and adults have been reported, but there is still no consensus. This study aims to highlight the use of individual patient characteristics to select optimal treatment strategies for CoA in adolescents and adults.

METHODS

Surgical repair of CoA was performed in five patients (mean age: 34 ± 14 years, range: 13-58 years). All patients had primary CoA, and one had aneurysm above the CoA. One patient had undergone previous aortic valve replacement (AVR) and graft replacement of the ascending aorta. One patient underwent resection of the coarctation without cardiopulmonary bypass (CPB) followed by direct end-to-end anastomosis. Three patients underwent CoA resection with an interposition graft through a lateral thoracotomy with partial CPB. One patient underwent AVR with extra-anatomical bypass (ascending-descending aorta).

RESULTS

No in-hospital deaths occurred, and there were no complications. During the follow-up period, there has been no recurrence of CoA.

CONCLUSION

CoA in adolescents and adults is associated with different issues from those encountered in infant patients, and comprehensive surgery should be performed in all cases.

摘要

目的

青少年及成人主动脉缩窄（CoA）相对少见。已有多种针对青少年及成人CoA的手术技术报道，但仍未达成共识。本研究旨在强调利用个体患者特征为青少年及成人CoA选择最佳治疗策略。

方法

对5例患者（平均年龄：34±14岁，范围：13 - 58岁）进行了CoA手术修复。所有患者均为原发性CoA，1例在CoA上方有动脉瘤。1例患者曾接受过主动脉瓣置换术（AVR）及升主动脉移植置换术。1例患者在非体外循环（CPB）下进行了缩窄段切除，随后直接进行端端吻合。3例患者通过侧胸切口在部分CPB下进行CoA切除并置入移植血管。1例患者通过解剖外旁路（升主动脉 - 降主动脉）进行了AVR。

结果

无住院死亡病例，也无并发症发生。在随访期间，CoA无复发。

结论

青少年及成人CoA与婴儿患者所遇到的问题不同，所有病例均应进行综合手术。