Involution of aneurysmal collateral arteries after correction of aortic coarctation

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Medical Case Report

Background:

• A 47-year-old male with a history of aortic coarctation underwent prior extra-anatomic bypass surgery via left thoracotomy.
• The patient presented a decade later with uncontrolled arterial hypertension.
• Complications included residual aortic coarctation, graft obstruction, and multiple collateral artery aneurysms.

Observation:

• The patient's uncontrolled hypertension was attributed to residual aortic coarctation, graft obstruction, and collateral artery aneurysms.
• These aneurysms were located between the subclavian artery and the aorta.
• Surgical intervention was deemed necessary to address these complex issues.

Findings:

• An extra-anatomic correction was performed, rerouting from the ascending aorta to the descending aorta.
• The procedure utilized conventional cardiopulmonary bypass and was accessed through a median sternotomy.
• Postoperative recovery was uneventful.

Implications:

• The surgical intervention resulted in the complete resolution of aneurysmal collateral arteries.
• This case highlights the potential for late complications after initial aortic coarctation repair.
• Successful extra-anatomic revascularization can effectively manage complex residual disease and associated aneurysms.