Procedimiento quirúrgico cardiovascular de alto riesgo en paciente que no permite transfusión sanguínea. Reporte de Caso

Abstract

Background: Coarctation of the aorta is a narrowing of the area of the ligamentum arteriosum; thus, depending on the anatomy, it may include a long segment, the aortic arch, or the abdominal aorta. The prevalence of this pathology, reported by the Spanish Heart Foundation and the Argentine Society of Cardiology, is 3 to 4 patients per 10,000 live births, predominantly males, with a 2:1 ratio with females. It is important to emphasize that the pathology presents clinical manifestations, such as increased blood pressure, dyspnea, intermittent claudication, systolic murmur, absence, delay or decrease of femoral pulses, and left ventricular hypertrophy, among others.

Case report: A clinical case of a 42-year-old Jehovah's Witness patient is presented, who developed aortic recoarctation and severe compromise of the lower limbs as intermittent claudication, which prevents her from performing her daily activities; the symptomatology reappears 15 years after a coarctation-correction-surgery was performed. The management performed on this patient consisted of performing a left axillary-femoral bypass without the need for complementary blood components during surgery to connect the aorta to the femoral artery subcutaneously and provide perfusion to the lower limbs —that were compromised and showed clear signs of claudication and cyanosis—. This case aims to explain the benefit of the surgical technique and its evolution after three years of surgery.