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Updated: Oct 1, 2025

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Coarctation of Aorta With Circumflex Aorta: Risk of Bronchial Compression and Recoarctation

Koji Miwa1, Shigemitsu Iwai1, Toshiaki Nagashima1

  • 1Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, Osaka, Japan.

The Annals of Thoracic Surgery
|March 1, 2022
PubMed

Insights

Congenital coarctation of the aorta with circumflex aorta is rare. Surgical repair requires careful consideration of aortic arch and descending aorta positioning to prevent complications like bronchial compression or recoarctation.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Congenital Heart Disease

Background:

  • Coarctation of the aorta (CoA) is a narrowing of the aorta, a major artery.
  • Circumflex aorta is a rare anatomical variation where the aortic arch courses posteriorly.
  • The combination of CoA and circumflex aorta presents unique surgical challenges.

Observation:

  • This report details the surgical treatment of three patients with coarctation of the aorta and circumflex aorta.
  • All patients underwent direct anastomosis for aortic arch repair.
  • Postoperative complications were observed in two patients, including left main bronchial compression.

Findings:

  • Two patients developed left main bronchial compression due to the descending aorta's traction toward the left side.
  • The third patient experienced recoarctation of the aorta, attributed to excessive surgical tension.
  • These complications highlight the complexities associated with this rare anomaly.

Implications:

  • Surgical strategies for coarctation of the aorta must account for the spatial relationship between the aortic arch and descending aorta.
  • Careful preoperative planning and intraoperative technique are crucial in cases involving circumflex aorta.
  • Addressing these anatomical nuances can improve outcomes and reduce the risk of postoperative complications in complex CoA repairs.

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