Open plugging and extra-anatomical bypass for iatrogenic rupture of coarctation of the aorta

We report a successful repair of aortic rupture after balloon angioplasty for re-coarctation using a unique approach and method. A 22-year-old woman underwent emergency surgery for aortic rupture after balloon angioplasty for postoperative aortic re-coarctation. We performed extra-anatomic bypass from the ascending aorta to the descending thoracic aorta through a median sternotomy and incision in the posterior pericardium. The transverse aortic arch was transected, and the distal aortic arch was opened under deep hypothermic circulatory arrest of the lower extremities. The proximal aorta was closed. To seal the aortic rupture site, a tube graft was inserted through the aortotomy and was oversewn with the aorta. Repair of the right ventricular outflow stenosis was concomitantly performed. The patient's postoperative course was uneventful, and she successfully gave birth 2 years postoperatively.