Modified Frozen Elephant Trunk Repair for Aortic Coarctation With Segmental Post-Stenotic Aneurysms

Aortic coarctation can be complicated by descending thoracic aortic aneurysms in adults. A 31-year-old man presented with exertional chest pain radiating to the back. Preoperative evaluation showed a 27-mmHg arm-leg systolic pressure gradient, echocardiographic coarctation with a 10-mm narrowest diameter and 25-mmHg gradient, and computed tomography showing two segmental post-stenotic aneurysms, the largest measuring 62 mm. He underwent one-stage modified frozen elephant trunk repair using a Medtronic thoracic stent graft sutured to a surgical graft. The postoperative gradient decreased to 5 mmHg, with stable 9-month follow-up.