Luosto R, Kyllönen K E, Merikallio E
Scand J Thorac Cardiovasc Surg. 1980;14(2):217-20. doi: 10.3109/14017438009101001.
Twenty-four aortic coarctation patients with minimal collaterals were operated on. Left-side bypass was used in 18 cases, internal shunt in 4, while a jump graft ws inserted in 2 cases. These methods were applied when the distal aortic pressure fell below 50 mmHg systolic during test clamping. The coarctation was corrected with isthmusplasty in 12 cases, resection and end-to-end anastomosis in 5 cases, resection with prosthetic replacement in 5 cases and jump graft in 2 cases. The operative mortality was 2 patients (8.3%). One patient died of complications of a post-perfusion bleeding tendency; the other, who had concomitant aortic insufficiency, died of cerebral infarction and pneumonia. At follow-up examination, the blood pressure difference between the upper and lower extremities had disappeared in all cases. The blood pressure was still over 150 mmHg systolic in 9 patients, 8 of whom received anti-hypertensive medication. One patient died during the follow-up period, while waiting for an operation for aortic insufficiency.
24例侧支循环极少的主动脉缩窄患者接受了手术治疗。18例采用左侧旁路，4例采用内分流，2例植入了搭桥移植物。当试验夹闭期间远端主动脉收缩压降至50 mmHg以下时采用这些方法。12例采用峡部成形术矫正缩窄，5例采用切除端端吻合术，5例采用人工血管置换术切除，2例采用搭桥移植物。手术死亡率为2例（8.3%）。1例死于灌注后出血倾向并发症；另1例合并主动脉瓣关闭不全，死于脑梗死和肺炎。随访检查时，所有病例上下肢血压差均消失。9例患者收缩压仍超过150 mmHg，其中8例接受了降压药物治疗。1例患者在随访期间等待主动脉瓣关闭不全手术时死亡。
