Abstract
Coral reef aorta is a rare form of aortic stenosis characterized by localized intraluminal heavy calcification of the juxtarenal and suprarenal aorta. Its main symptoms are hypertension, renal dysfunction, visceral ischemia, and intermittent claudication caused by hypoperfusion. We report 2 cases of extra-anatomical bypass for coral reef aorta. A 73-year-old woman was admitted after presenting with dyspnea and oliguria. Thoracoabdominal computed tomography (CT) showed subtotal occlusion of the heavily calcified aorta at the level of the celiac artery. A right axillo-femoral bypass was performed, which successfully improved her cardiac and renal function, but she still had intermittent claudication that required an additional left axillo-femoral bypass. After the second operation, her symptoms disappeared completely. Another 73-year-old woman was admitted complaining of intermittent claudication. Thoracoabdominal CT demonstrated a densely calcified occlusive lesion of the infrarenal abdominal aorta. A right axillo-bifemoral bypass was performed, and her condition improved. Surgical options for coral reef aorta include thromboendarterectomy, graft replacement, extra-anatomical bypass, and endovascular stent-graft. For patients in poor clinical condition, extra-anatomical bypass may be more efficient than a radical surgical procedure.
