INTERRUPTED AORTIC-ARCH - FORTUITOUS DIAG NOSIS IN A 72-YEAR-OLD WOMAN WITH SEVERE REGURGITATION

Interrupted aortic arch, defined as complete luminal and anatomic disc ontinuity between ascending and descending aorta, is an uncommon and h ighly lethal anomaly. We report the case of a 72-year-old woman schedu led for aortic valve replacement because of severe regurgitation. Duri ng preoperative catheterization, it was not possible to reach the asce nding aorta from a femoral puncture. Further radiological investigatio n demonstrated interrupted aortic arch of type A without other cardiac or vascular anomalies. Postoperative course after aortic valve replac ement and ascending-to-supraceliac aortic bypass was initially unevent ful. Unfortunately, pericardial tamponade developed 10 days after the operation and required re-exploration, during which no active bleeding could be found. Recurrent effusion occurred and the patient finally d ied from severe shock and multiorgan failure. This exceptional case pr ompted a review of the literature which confirmed the rarity of this p resentation in adult patients. It seems interesting that only mild art erial hypertension of the upper extremities was retrospectively found in this patient.