A 28-year-old man was referred for hypertension of 160/92 mmHg that was poorly controlled medically. However, he had no signs of lower limb ischemia; he had diminished femoral pulses and ankle-brachial indices of 0.7 bilaterally on physical examination. Computed tomography revealed coarctation of the abdominal aorta, beginning just below the takeoff of both renal arteries and extending above the inferior mesenteric artery. A 14-mm woven dacron aorto-aortic bypass, sutured end-to-side to the proximal descending thoracic aorta above and to the infrarenal abdominal aorta below, as well as right renal artery reconstruction were performed. The postoperative course was uneventful and he continues to have normal blood pressure and normal femoral pulses.
Middle aortic syndrome, abdominal aortic coarctation, hypertension