Extra-anatomic aortic bypass for complex (re-) coarctation and hypoplastic aortic arch in adolescents and adults.

Various surgical approaches have been proposed for complex (re-) coarctation and aortic arch hypoplasia (AAH). We report seven patients (mean age 19.6+/-9.5 years) with complex coarctation or re-coarctation and AAH successfully treated by extra-anatomic ascending-to-descending aortic bypass (ADB) via sternotomy between 1995 and 2002 without mortality and no relevant complication early postoperatively and during a follow-up of 24+/-29 (0.2-84) months. ADB may therefore be considered in selected patients with (re-) coarctation with AAH, with the need for concomitant ascending aortic or cardiac surgery and in patients with aortic arch stenosis and increased risk of complications under DHCA.