[Axilla-iliac bypass in a patient with aortic obstruction progressed from atypical coarctaion]

A case of a 13 year-old girl with abdominal aortic obstruction is presented. At the age of nine years she underwent an evaluation for a continuous murmur heard over the left costal margin. The blood pressure was 210/125 mmHg in the ascending aorta, and an aortography revealed a critical stenosis in the descending aorta proximal to the origin of the celiac artery. No surgical treatment was recommended at this time. At the age of 13 years she developed severe headache and was admitted for the second time. Upon catheterization the ascending aortic pressure was 242/150 mmHg, and an aortography revealed total obstruction of the abdominal aorta in the segment proximal to the celiac artery. An extraanatomical bypass was constructed between the right axillary artery and the right common iliac iliac artery with a 10 mm dacron graft. Two weeks after this procedure, the blood systolic pressure was 110 mmHg in the upper extremities. It has been 12 months since the patient had this procedure, and she continue to do well, i.e., she has no particular limitations of the hip joint movement, has no headache, and remains to be normotensive.