Correction of Interrupted Aortic Arch in an Adult: Ascending-to-Descending Aorta Bypass

Abstract

A female patient, 24 years old, presented with arterial hypertension since 17 years old, in use of losartan (50 mg twice a day) and hydrochlorothiazide (25 mg once a day). Her medical history includes asthmatic bronchitis and a C-section 3 years ago. She has no allergies. Physical examination revealed a 220 × 120 mmHg blood pressure in both right and left superior members and systolic pressure of 120 mmHg in left inferior member; saturation of oxygen was 97%; pulmonary auscultation was normal. The magnetic resonance imaging showed a low diameter in distal aortic arch and in the descending aorta. It also showed an interrupted aorta at isthmus level. The echocardiogram evidenced a normal left ventricular ejection fraction (63%). A cranial computerized tomography scan showed dilated vessels without aneurysms. The patient was submitted to evaluation of a cardiac surgeon, who indicated a surgical correction of the pathology. The surgical team performed an end-to-side anastomosis with a Goretex graft 18 mm and the descending aorta and the ascending aorta. She was discharged from the ICU at the 2nd postoperative day, and the physical examination revealed blood pressure of 130 × 80 mmHg at the left superior member, 140 × 90 mmHg at the right superior member, and systolic above 160 mmHg at the right inferior member.