CC BY 4.0 · Aorta (Stamford) 2021; 09(06): 228-230
DOI: 10.1055/s-0041-1739483
Case Report

Role of Extra-anatomic Ascending to Descending Bypass in Complex Thoracic Aortic Pathology

1   Department of Cardiac Surgery, Instituto Cardiovascular Buenos Aires, Buenos Aires, Argentina
Sebastian Pagni
2   Department of Cardiac Surgery, Baptist Health Louisville, Louisville, Kentucky
› Author Affiliations
Funding None.


Complex pathology of the distal arch and proximal descending thoracic aorta is usually approached by stent endografting or in situ graft replacement. Oftentimes, these options are not feasible due to unfavorable anatomy, multiple previous procedures, active infection, or presence of concomitant cardiac disease. Thoracic aortic extra-anatomic bypass, as part of an open surgical strategy, is a useful and often the only curative option left for the treatment in these patients. Herein, we describe two cases that illustrate the utility of extra-anatomic thoracic aortic bypass for complex aortic disease.

Publication History

Received: 11 September 2020

Accepted: 02 July 2021

Article published online:
28 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

  • References

  • 1 Vijayanagar R, Natarajan P, Eckstein PF, Bognolo DA, Toole JC. Aortic valvular insufficiency and postductal aortic coarctation in the adult. Combined surgical management through median sternotomy: a new surgical approach. J Thorac Cardiovasc Surg 1980; 79 (02) 266-268
  • 2 Heinemann MK, Ziemer G, Wahlers T, Köhler A, Borst HG. Extraanatomic thoracic aortic bypass grafts: indications, techniques, and results. Eur J Cardiothorac Surg 1997; 11 (01) 169-175
  • 3 Said SM, Burkhart HM, Dearani JA, Connolly HM, Schaff HV. Ascending-to-descending aortic bypass: a simple solution to a complex problem. Ann Thorac Surg 2014; 97 (06) 2041-2047 , discussion 2047–2048
  • 4 Elefteriades JA, Hartleroad J, Gusberg RJ. et al. Long-term experience with descending aortic dissection: the complication-specific approach. Ann Thorac Surg 1992; 53 (01) 11-20 , discussion 20–21
  • 5 Pagni S, Ganzel BL, Edmonds Jr HL. Alternative surgical strategy for the treatment of a mycotic aortic arch aneurysm. Tex Heart Inst J 2006; 33 (03) 356-358
  • 6 Tang Y, Han L, Fan X. et al. Extra-anatomical bypass to treat aortic endograft infection after thoracic endovascular aortic repair. Interact Cardiovasc Thorac Surg 2020; 30 (04) 620-622