Aortic coarctation and associated cardiac lesions – optimal therapeutic approach: report of 2 cases

Milos Velinovic; Radmila Karan; Nataša Kovačević-Kostić; Biljana Obrenović-Kirćanski; Milica Vraneš-Stojimirov; Vladimir Milićević; Dejan  Nikolić; Dragan Milić

doi:10.2298/VSP171018027V

Milos Velinovic University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Cardiac Surgery Clinic, Belgrade, Serbia
Radmila Karan University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Cardiac Surgery Clinic, Center for Anesthesiology, Belgrade, Serbia
Nataša Kovačević-Kostić University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Cardiac Surgery Clinic, Center for Anesthesiology, , Belgrade, Serbia
Biljana Obrenović-Kirćanski University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Milica Vraneš-Stojimirov University of Belgrade, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia
Vladimir Milićević Clinical Center of Serbia, Cardiac Surgery Clinic, Belgrade, Serbia
Dejan Nikolić University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia
Dragan Milić University of Niš, Faculty of Medicine, Niš, Serbia; Clinical Center of Niš, Clinic for Cardiovascular Surgery, Niš, Serbia

DOI: https://doi.org/10.2298/VSP171018027V

Ključne reči: aorta, aneurizma, aorta, koarktacija, zalistak, aortni, insuficijencija, ehokardiografija, hirurgija, kardijalna, procedure, lečenje, ishod

Sažetak

Apstrakt

Uvod. Koarktacija aorte je kongenitalno stanje koje se najčešće otkriva i leči u detinjstvu. Odrasli bolesnici sa koarktacijom i pridruženim srčanim oboljenjima predstavljaju pravi izazov i temu za stručne polemike oko adekvatnog načina lečenja. Prikazana su dva bolesnika sa koarktacijom aorte kod kojih je hiruški tretman bio neophodan. Prikaz bolesnika. Prvi bolesnik bio je muškarac star 61 godinu sa prethodno ugrađenom mehaničkom aortnom valvulom. U jednom aktu je urađena rekonstrukcija koarktacije aorte i operativno zbrinjavanje aneurizme ascendentne aorte. Drugi bolesnik bila je 49-godišnja žena sa aneurizmom aorte, bikuspidnom aortnom valvulom, teškom aortnom insuficijencijom i koarktacijom aorte ispod odvajanja arterije supklavije. Urađena je Bental operacija i operacija bajpasa između ascendentne i torakalne aorte. Kod oba bolesnika je postoperativni tok protekao bez komplikacija. U periodu praćenja od 1 i 3 godine nije bilo komplikacija. Zaključak. Operacija u jednom aktu je bolji izbor kod bolesnika sa pridruženom patologijom kao što je aneurizma aorte i bolest aortne valvule. Svakog bolesnika treba pojedinačno razmotriti i doneti odluku o najpogodnijoj hirurškoj intervenciji.

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Koarktacija aorte i pridružene lezije srca – optimalni terapijski pristup

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