Off-Pump Extraanatomic Aortic Bypass for the Treatment of Complex Aortic Coarctation and Hypoplastic Aortic Arch Florian S. Schoenhoff, MD, Pascal A.

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Off-Pump Extraanatomic Aortic Bypass for the Treatment of Complex Aortic Coarctation and Hypoplastic Aortic Arch Florian S. Schoenhoff, MD, Pascal A. Berdat, MD, Mladen Pavlovic, MD, Alexander Kadner, MD, Markus Schwerzmann, MD, Jean- Pierre Pfammatter, MD, Thierry P. Carrel, MD The Annals of Thoracic Surgery Volume 85, Issue 2, Pages 460-464 (February 2008) DOI: 10.1016/j.athoracsur.2007.10.063 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Intraoperative situs after replacement of the ascending aorta and extraanatomic aortic bypass in an 18-year old girl with ascending aneurysm combined with hypoplastic aortic arch and significant coarctation. The Annals of Thoracic Surgery 2008 85, 460-464DOI: (10.1016/j.athoracsur.2007.10.063) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Postoperative magnetic resonance-angiography after extraanatomic ascending-to-descending aortic bypass. The Annals of Thoracic Surgery 2008 85, 460-464DOI: (10.1016/j.athoracsur.2007.10.063) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Three-dimensional volume images of extraanatomic aortic bypass in a 31-year-old woman (A) with multiple previous interventions, including resection and patch angioplasty, percutaneous dilatation, redo-surgery due to recoarctation, and finally Wallstent (Schneider [USA] Inc, Minneapolis, MN), implantation (B) to exclude a pseudoaneurysm. Extraanatomic bypass was necessary to restore adequate perfusion of the lower extremities and was associated with transposition of the left subclavian artery into the left common carotid artery which was connected to the ascending aorta using an 8-mm Dacron graft (Boston Scientific Corp, Natick, MA). The Annals of Thoracic Surgery 2008 85, 460-464DOI: (10.1016/j.athoracsur.2007.10.063) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions