Coarctation of the thoraco-abdominal aorta: operative treatment with a cryopreserved arterial homograft in a seven-year-old boy.

Compared to coarctation in the proximal descending aorta near the insertion of the ligamentum arteriosum, coarctation in the aortic arch, the lower descending or the abdominal aorta is a relatively rare disease. Operative treatment of abdominal coarctation is more complicated if there are concomitant stenoses of visceral or renal arteries. In young patients, surgical procedure and outcome is additionally determined by caliber and compliance mismatch between still growing native vessels and arterial substitute. Our report deals with a seven-year-old male patient, who was first diagnosed as having coarctation of the aorta at five years of age due to distinct bilateral brachial hypertension. The angiogram revealed a narrowing of the aorta, approximately ten centimeters in length, from the lower descending segment down to the proximal abdominal part of the aorta. The origin of the superior mesenteric artery and both renal arteries were not involved in the pathological process. Arterial reconstruction was carried out by anastomosis of cryopreserved arterial homograft with the thoracic aorta and with the abdominal aorta distal to the origin of the renal arteries. The postoperative course was uneventful, duplex sonography revealed no pressure gradient between the thoracic and abdominal aorta and brachial blood pressure was within normal ranges.