简介：BackgroundTheconventionalextra-anatomicbypassisoriginatedfromtheaxillary'sarteryandthegraftsizeisoftenlimitedduetothesmalldiameterofaxillary'sartery.Extra-anatomicbypassgraftoriginatingfromascendingaortacanimprovethegraftsizeanddistalperfusion,butneedsternotomywhichmighthavehigheroperativeriskscomparedwithaxillo-femeralbypass.Wesummarizeourexperiencesofextra-anatomicbypassfromascendingaortaforatypicalaorticcoarctation.MethodsBetweenJanuary2005andFebruary2008,5womenagedfrom18to64yearsunderwentextra-anatomicbypassfromascendingaortatoabdominalaortaoriliacarterybypassfortreatmentofatypicalaorticcoarctation.Preoperatively,allpatientshadhypertensionandneededanti-hypertensivemedications.Systolicbloodpressurewas151±9mmHg.Anklepressureindex(API)were0.60±0.23inleftand0.56±0.23inright.Averagesystolicpressuregradientofaorticstenosiswas76±18mmHg.Threepatientsunderwentconcomitantcardiacoperation,includingcoronaryarterybypassgrafting,Bentallprocedureandatrialseptaldefectrepair.ResultsTherewasnohospitalandlatemortalityduring58±15monthsfollow-up(rangefrom44to81months).Postoperativesystolicbloodpressurewasreducedto126±11mmHgatthetimeofdischarge.Allpatientsmaintainednormalbloodpressurewithoutmedicationduringfollow-up.APIwasimprovedto1.12±0.24inleftand1.17±0.25inright(comparedwithpreoperativedata,P<0.05).Follow-upcomputertomographyshowedpatencyinallgrafts.ConclusionsSurgicaltreatmentofatypicalaorticcoarctationwithextra-anatomicbypassoriginatingfromascendingaortaalleviateshypertensionandlowlimbischemia.