[One-staged surgery for coarctation of the aorta associated with annuloaortic ectasia--a case report]

A 37-year-old man was admitted to St. Marianna University Hospital with an episode of severe anterior chest pain. Contrast enhanced CT scan and digital subtraction angiography disclosed an aneurysmal dilatation of the aortic root and almost completely obstructed aortic isthmus. Modified Bentall operation was performed with simultaneous graft bypass using a woven Dacron prosthesis between the ascending aorta and the abdominal aorta through the median thoracoabdominal incision. Histologically the aortic wall showed cystic medial necrosis, and the aortic valve showed myxomatous degeneration. Only 9 cases with coarctation of the aorta associated with annuloaortic ectasia have been reported in the Japanese literature, and this is believed to be the first report that one-staged surgery has successfully been done dealing simultaneously both the coarctation and the annuloaortic ectasia.