Incidental recurrence of high-grade coarctation of the aorta in a child

Abstract This case report describes a high-grade recurrent aortic coarctation incidentally detected in a 7-year, 10-month-old girl, seven years after primary balloon dilatation. Echocardiography identified narrowing of the descending aortic arch. Computed tomography of the chest with three-dimensional reconstruction further delineated severe focal stenosis at the aortic isthmus, adjacent to the left subclavian artery origin, with a minimal luminal diameter of 0.5 cm. Post-stenotic dilation of the proximal descending aorta measured up to 2.7 cm. The patient underwent successful surgical repair with artificial vascular bypass under extracorporeal circulation. Postoperative imaging confirmed graft patency. Symptoms resolved after surgery, and the patient continues under long-term follow-up. This case highlights the risk of delayed, severe recoarctation after balloon angioplasty and emphasizes the importance of sustained imaging surveillance in these patients.