Interrupted aortic arch with massive saccular collateral aneurysm in an adult.

A 49-year-old man was diagnosed with an interrupted aortic arch (IAA), a massive saccular thoracic collateral aneurysm, ischemic renal insufficiency, and multiple abdominal collateral aneurysms. A bypass from the left subclavian artery to the descending aorta and thoracic collateral aneurysmectomy proceeded simultaneously through a posterolateral thoracotomy. The pressure gradient between upper and lower extremities disappeared and renal function was normalized. Thoracic collateral aneurysmectomy and a simultaneous bypass from the left subclavian artery to the descending aorta with postoperative normalization of ischemic renal insufficiency are extremely rare in adult patients with IAA, and the remaining abdominal collateral aneurysms require careful monitoring.
(Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)