Abstract
A 25-year-old man was admitted to our hospital with a diagnosis of residual coarctation of the aorta. He had undergone repair for coarctation of the aorta at the age of 2 and extra-anatomical bypass grafting at the age of 14. However, because he had repeated graft infection at the age of 24, he underwent graft removal and covering by an omentum flap. The size of the aortic arch and descending aorta was 10 mm, and the pressure gradient between the arms and legs was 60 mmHg. We performed a total arch replacement and descending aorta bypass graft for the residual coarctation. We used an aortic no touch technique under deep hypothermic circulatory arrest to avoid potential aortic injury. Furthermore, we devised an operation method from the viewpoint of spinal cord protection and minimized adhesion detachment using an aortic navigation system. The postoperative course was uneventful, and he did not suffer from paraplegia. He was discharged 20 days after surgery without medication. The strategy of our operation is a safe and effective option for residual coarctation.
