A successful case of ascending aorta--abdominal aorta bypass for middle aortic syndrome

The middle aortic syndrome (MAS) is a rare disease affecting children and young adults, and it occurs in about 0.5% to 2.0% of all aortic coarctation cases. Congenital, acquired, inflammatory, and infectious etiologies have been described. In the majority of cases, there is a short, isolated or diffuse tubular narrowing of the descending thoracic and abdominal aorta, often accompanied by ostial stenosis or occlusion of the renal and visceral branches, which leads to renovascular hypertension and visceral ischemia. Surgical treatment should be considered in cases of uncontrollable hypertension, evidence of end-organ damage such as cardiac failure, progressive renal insufficiency, or severe intermittent claudication. Several surgical treatments for this condition have been reported, including bypass grafting, graft replacement, or patch angioplasty. We report a successful case of ascending aorta-abdominal aorta bypass for MAS in a 11-year-old boy.