Annals of pediatric cardiology
July 31, 2026 · via Europe PMC
Aortic dissection distal to coarctation of the aorta with severe coronary artery disease: A case report and surgical review of a rare combination of adult congenital and acquired heart diseases.
George JR, Radhakrishnan R, Anandakuttan S.
AI summary — for doctors, generated from the abstract only
This case report describes successful simultaneous surgical repair of aortic dissection and coronary artery disease complicating adult coarctation of the aorta, illustrating that combined repair is feasible with careful planning in this rare and high-risk combination.
What was studied
A case report of a 46-year-old man with previously undiagnosed coarctation of the aorta, who presented with acute aortic dissection distal to the coarctation and was found to have severe triple-vessel coronary artery disease, describing his combined surgical treatment with coarctation repair (Dacron graft) and triple coronary artery bypass grafting.
Key findings
- The patient presented with acute tearing chest and back pain and was found on imaging to have a previously undiagnosed coarctation of the aorta with a Stanford type B dissection distal to the coarcted segment.
- Coronary angiography revealed triple-vessel coronary artery disease.
- Combined open surgical repair (coarctation resection with Dacron graft replacement plus triple coronary artery bypass grafting) was performed, with uneventful recovery and durable repair with patent grafts confirmed on follow-up imaging.
Clinical relevance
This case highlights that adults with uncorrected or residual coarctation of the aorta require vigilance for aortic complications, and suggests that simultaneous repair of coarctation-associated dissection and coronary revascularization is feasible with meticulous surgical planning, though this is based on a single case.
Who should care
Limitations
This is a single case report; findings cannot be generalized to predict outcomes or guide treatment approach in other patients with this rare combination of conditions.
Surgeons successfully treated a rare combination of a torn aorta and severe coronary artery disease in one operation in a patient with a previously undiagnosed congenital aortic narrowing.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Coarctation of the aorta (CoA) persisting into adulthood is uncommon and may be complicated by hypertension and aortic pathology. Aortic dissection occurring distal to a coarctation segment in the presence of advanced coronary artery disease (CAD) is not uncommon, but its description in the literature - especially the management - is rarely reported. A 46-year-old male with no prior symptoms or history of comorbid illness presented with acute, tearing chest and back pain. Echocardiography revealed a CoA. Further evaluation with computed tomography angiography demonstrated a Stanford type B aortic dissection distal to the coarcted segment, and coronary angiography showed triple-vessel CAD. He underwent an open surgical repair with resection of the coarctation and Dacron graft replacement, along with triple coronary artery bypass grafting. Recovery was uneventful, and follow-up imaging confirmed durable repair and patent grafts. Vigilance for aortic complications in adults with uncorrected or residual coarctation is essential. Simultaneous repair of coarctation-associated dissection and coronary revascularization is feasible with meticulous planning.
DOI
10.4103/apc.apc_306_25
PMID
42602776
PMCID
PMC13475826
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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