Ascending-to-Abdominal Aortic Bypass Grafting in a Case of Middle Aortic Syndrome

Abstract

Symptomatic aortic stenosis in adults causes complications such as secondary hypertension, heart failure, abdominal organ perfusion failure, and lower limb ischemia ; therefore, medical management is difficult. Although there are reports of endovascular treatment using a catheter and surgery as treatment methods, there is no consensus on the treatment strategy. An 82-year-old woman was admitted to our hospital because of high blood pressure and heart failure. She underwent ascending-to-abdominal aortic bypass grafting with cardiopulmonary bypass. Proximal anastomosis was established during cardiac arrest. We performed the anti-anatomical anastomotic procedure using a large artificial graft, which was guided directly from the posterior pericardium to the retroperitoneal cavity. Although the surgery was highly invasive, the patient exhibited a favorable outcome. We report this case because the treatment method may be useful as one of the curative treatments for middle aortic syndrome.