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Eur J Cardiothorac Surg 2002;22:836-838
© 2002 Elsevier Science NL

Case report

Surgical treatment of atypical aortic coarctation associated with occlusion of all arch vessels in Takayasu's disease

First Department of Surgery, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan

Received 7 June 2002; accepted 21 August 2002.

* Corresponding author. Tel.: +81-82-257-5218; fax: +81-82-257-5219
e-mail: sugawara{at}hiroshima-u.ac.jp

We report a patient with Takayasu's disease surgically treated who had presented severe manifestation due to aortic coarctation associated with occlusion of all arch branches. This patient had suffered cardiac failure and recurrent fainting attacks before surgery. The operative procedures included ascending to infra-renal aortic bypass grafting combined with reconstruction of the right axillary artery. Cardio-pulmonary bypass (CPB) was used to facilitate the proximal aortic anastomosis. Regional oxygen saturation in the bilateral frontal lobes was measured intraoperatively using near-infrared spectroscopy to detect cerebral ischemia. Regional oxygen saturation was managed above the critical level throughout the CPB. No new cerebral complications occurred in the perioperative period.

Key Words: Surgical treatment • Cardio-pulmonary bypass • Takayasu's disease • Aortic coarctation