Long-Term Follow-Up And Outcome In Patients With An Extra-Anatomic Ascending-Descending Aortic Bypass For Complex Coarctation And Aortic Arch Pathology

Background: Extra-anatomical ascending-descending aortic bypass (EAADAB) is a safe surgical option for the relief of complex coarctation and aortic arch obstruction, but long-term functional outcome is lacking. Methods: Retrospective analysis of all patients who underwent EAADAB at our institution between 1/1981 and 6/2017. Results: Twenty-one patients (n=9 females, 8 in child-bearing age), mean age 35.9±10.2 years, were identified. Mean follow-up is 12.1±8.5 years and is complete. Mean age at operation was 23.8 ± 12.3 years. Fourteen patients had undergone previous aortic arch interventions. Two late deaths occurred: one due to HIV, one caused by an intra-cerebral bleeding from an arterio-venous malformation, 16 and 13 years postoperatively. Three patients required re-intervention: two for pseudoaneurysm, one for a stenotic distal anastomosis, 32,13, and 7 years postoperatively respectively. Echocardiography showed left ventricular hypertrophy in 3 patients and diastolic dysfunction (grade I and II) in 6...