Bercot M, Moulucou A, Ledoze H, Menasche P, Piwnica A
J Mal Vasc. 1982;7(3):209-12.
Coarctations of the thoraco-abdominal aorta are rare malformations. Whilst determining the need for surgery, in general because of hypertension, raises few problems, the choice of surgery tactics gives rise to discussion. The choice must above all take into account the risks of visceral ischaemia, in particular affecting the spinal cord, the causes of which are at one and the same time technical (total aortic clamping, sacrifice of the intercostal arteries) and haemodynamic (blood pressure variations). Under such conditions, it would seem necessary to reject resection-suture. Discussion is thus limited to aortoplasty with a widening patch, which is suitable in particular for short stenoses of easy access and to by-pass from ascending aorta to abdominal aorta, electively more indicated in cases of extensive coarctation with severe periaortitis, though the long-term fate of such by-passes remains uncertain.
胸腹主动脉缩窄是一种罕见的畸形。虽然确定是否需要手术（通常是由于高血压）很少有问题，但手术策略的选择却引发了讨论。选择首先必须考虑内脏缺血的风险，特别是影响脊髓的风险，其原因同时涉及技术因素（主动脉完全阻断、肋间动脉牺牲）和血流动力学因素（血压变化）。在这种情况下，似乎有必要摒弃切除缝合术。因此，讨论仅限于用补片扩大的主动脉成形术，这种方法特别适用于易于处理的短段狭窄以及从升主动脉到腹主动脉的旁路手术，对于伴有严重主动脉周围炎的广泛缩窄病例，选择性地更倾向于采用这种方法，尽管这种旁路手术的长期效果仍不确定。
