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Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
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Middle aortic coarctation.

Thea P Price1, Anumeha K Whisenhunt1, Aleksandra Policha1

  • 1Thomas Jefferson University Hospitals, Philadelphia, PA.

Annals of Vascular Surgery
|December 24, 2013
PubMed
Summary
This summary is machine-generated.

Middle aortic coarctation (MAC) is rare, often presenting in youth. This case highlights a successful open surgical bypass for late-presenting MAC in a 52-year-old, improving hypertension and renal function.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Medical Case Reports

Background:

  • Middle aortic coarctation (MAC) is a rare vascular condition, typically diagnosed in younger individuals.
  • It classically manifests as severe hypertension, abdominal angina, and lower extremity claudication.
  • Open surgical bypass is the established treatment for MAC to restore blood flow and manage renovascular hypertension.

Observation:

  • A 52-year-old male presented with a late diagnosis of MAC, experiencing severe, refractory hypertension since age 8.
  • Symptoms included acute chest pain and unpalpable distal pulses, with elevated creatinine levels.
  • CT angiography revealed coarctation of the descending thoracic aorta with extensive collateral circulation.

Findings:

  • The patient underwent a descending thoracic aorta-infrarenal aortic bypass using a Hemashield tube graft.
  • Surgical repair involved a complex approach with anterolateral thoracotomy and a retroperitoneal incision.
  • Postoperatively, the patient showed significant improvement, with reduced antihypertensive medications, restored pulses, and improved renal function.

Implications:

  • This case demonstrates the feasibility of open surgical repair for late-presenting MAC, even in complex anatomical scenarios.
  • Successful surgical intervention can significantly alleviate symptoms of renovascular hypertension and improve long-term outcomes.
  • Highlighting the importance of considering MAC in adult patients with refractory hypertension and vascular complications.