Aortic Resection and Replacement for Coral Reef Aorta Involving Severe Obstructive Calcification: A Case Report

Coral reef aorta (CRA) is a rare aortic condition characterized by calcifications protruding into the lumen, resulting in severe stenosis that can lead to symptoms such as intermittent claudication in the lower limbs and intestinal ischemia. Some patients may progress to fatal conditions such as intestinal ischemia or congestive heart failure. A 74-year-old female was referred to our hospital with intermittent claudication and severe calcification of the abdominal aorta. Computed tomography (CT) scans revealed extensive calcification of the infrarenal abdominal aorta, with protrusions into the lumen, resulting in severe stenosis. After a thorough discussion with catheter interventionists, we concluded that graft replacement was a reasonable option, offering a lower risk of re-intervention compared with endovascular surgery. Considering the sites for aortotomy and anastomosis, we assessed that prosthetic graft replacement was more suitable than endarterectomy or bypass. Under general anesthesia, the patient underwent a laparotomy through a midline abdominal incision. The calcified aorta was resected and reconstructed with a prosthetic graft. She showed improvement in intermittent claudication postoperatively, and she was discharged home on postoperative day 13. No recurrence of symptoms has been observed during the one-year follow-up period.