Sweeney M S, Walker W E, Duncan J M, Hallman G L, Livesay J J, Cooley D A
Ann Thorac Surg. 1985 Jul;40(1):46-9. doi: 10.1016/s0003-4975(10)61168-x.
To define the safety and efficacy of operation for recurrent thoracic aortic coarctation, we reviewed the hospital records and subsequent courses of 53 patients who underwent such procedures over a 23-year period. Previous operations included end-to-end anastomosis, prosthetic patch or subclavian flap aortoplasty, and prosthetic interposition or bypass grafts, performed in patients ranging from 1 day to 44 years old. Several different reoperative procedures were used, including an ascending-descending aortic bypass graft in 4 patients who had had two previous repairs. There were no hospital or late deaths and only 3 relatively minor complications. Only 2 patients have hypertension requiring drug therapy at follow-up, which now averages 7 years. We conclude that operative management of severe, recurrent coarctation is both safe and effective, and that several techniques of reconstruction may have a place in such therapy.
为明确复发性胸主动脉缩窄手术的安全性和有效性，我们回顾了53例在23年期间接受此类手术患者的医院记录及后续病程。既往手术包括端对端吻合术、人工补片或锁骨下皮瓣主动脉成形术，以及人工血管置换或旁路移植术，患者年龄从1天至44岁不等。采用了几种不同的再次手术方法，包括4例曾接受过两次修复手术的患者进行升主动脉-降主动脉旁路移植术。无住院死亡或晚期死亡病例，仅有3例相对轻微的并发症。随访平均7年，仅2例患者在随访时有高血压需要药物治疗。我们得出结论，严重复发性缩窄的手术治疗既安全又有效，并且几种重建技术在此类治疗中可能有一席之地。
