Abstract
Mid-aortic syndrome (MAS) is a rare disease found in children and young adults. This syndrome is characterized by the segmental narrowing of the descending thoracic and the proximal abdominal aorta and is often accompanied by ostial stenosis of its major branches. We present a case of a 4-year-old boy with abdominal aortic obstruction which progressed from MAS. At 1 month of age he underwent evaluation for a continuous murmur and hypertension of the upper body. Magnetic resonance angiography and aortography showed stenosis in the descending thoracic and abdominal aortas, proximal to the origin of the celiac artery. However, his hypertension was not controlled by the administration of anti-hypertensive agents. At 3 years of age, aortography and computed tomography (CT) revealed an aortic obstruction proximal to the celiac artery. Therefore, we performed an extra-anatomical bypass from the ascending aorta to the abdominal aorta with an 8-mm ring-supported ePTFE graft. After surgery, the difference in blood pressure between the upper and lower limbs resolved and postoperative CT images showed good graft patency.
