Coral reef aorta: A long-term study of 21 patients

Coral reef aorta is a rare calcifying disease of the juxtarenal and suprare nal aorta. We report here our surgical experience in treating 21 patients, with a mean follow-up of 4 years and 7 months. Both genders were equally af fected. Ten male (48%) and 11 female (52%) patients with a mean age of 54.6 years (range 42-76 years) underwent surgery. The main symptoms were limb c laudication (n = 11, 52%), renovascular stenosis (n = 9, 43%) with concurre nt renovascular hypertension (n = 5, 24%), and angina abdominalis (n = 7, 3 3%). Most patients had multiorgan vascular disease such as iliofemoral arte rial occlusive disease (n = 14, 66%), coronary artery obstruction (n = 8, 3 8%), or obstruction of the carotid artery (n = 6, 28%). Risk factors did no t differ between coral reef patients and those with other occlusive vascula r diseases. All patients were treated through vascular operations, includin g open thromboendarterectomy of the suprarenal (n = 9, 43%), infrarenal (n = 4, 19%), or supra- and infrarenal aorta (n = 8, 38%), and thromboendarter ectomy of the following vessels: celiac artery (n = 7, 33%), superior mesen teric artery (n = 12, 57%), inferior mesenteric artery (n = 3, 14%), unilat eral renal artery (n = 3, 14%), or bilateral renal artery (n = 9, 43%). Byp ass reconstructions were performed in 39% (n = 8). A thoracoabdominal appro ach was used in 14 patients (67%) and a median laparotomy in 7 (33%). Our r esults show that coral reef aorta is not confined to either gender. It appe ars most frequently in the context of general atherosclerotic disease and p atients benefit from timely diagnosis and operation before onset of severe, life-threatening visceral and renal complications.