[Adult coarctation of aorta repaired under partial selective cerebral perfusion]

We report a case of an adult coarctation of aorta in a 46-year-old woman repaired with partial selective cerebral perfusion. Preoperative cardiac catheterization revealed that pressure gradient between the upper and lower limb was more than 60 mmHg. Under general anesthesia, we entered the left thoracic cavity through standard thoracomy, and removed the coarctation of aorta under partial selective cerebral circulation. The left common carotid artery and the descending aorta were cannulated and perfused, and the main pulmonary artery was cannulated for venous drainage. The aortic arch was cross-clamped just proximal to the left common carotid artery. Reconstruction was carried out by graft replacement using a side armed 16 mm Dacron graft between the aortic arch and the descending aorta, and the left subclavian artery was connected to the side arm of the graft. Postoperatively, there is no pressure difference between the upper and lower extremities.