Anatomic revascularization with open thoracoabdominal aortic repair for extensive coral reef aorta: A case report

A coral reef aorta (CRA) is a rare aortic occlusive disease. Various less invasive approaches have been proposed for CRAs with extensive calcification of the entire aorta, but they are often technically difficult. A case of successful treatment of a patient with an extensive coral reef aorta by open thoracoabdominal aortic repair (TAAR) is reported. A 64-year-old man presented with a left foot ulcer with an infection following impaired wound healing. Computed tomography (CT) showed extensive CRA and lower extremity arterial disease (LEAD). Anatomic revascularization with open TAAR for extensive CRA and endovascular treatment for LEAD were performed. Although blood flow improved postoperatively, left lower limb amputation was required because of poor infection control. The clinical course after amputation was uneventful, and the patient was discharged on postoperative day 52. In conclusion, open TAAR for extensive CRA is challenging, but it should be considered in complicated cases.