CALCIFIED AND DILATED ASCENDING AORTA DUE TO ATHEROMATOUS OCCLUSIVE DISEASE SIMULATING COARCTATION OF THE AORTA

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Abstract
The case of a 21-yr. old woman with hypertension, calcification, dilatation of the ascending aorta, and partial occlusion of the descending aorta just beyond the left subclavian artery simulating congenital coarctation of the aorta is described. Aortotomy, 7 yr. later at the age of 28 yr., revealed occlusion of the aorta due to calcified atheromatous thrombus. Within a 6 yr. period, extension of the disease into the aortic arch vessels probably caused basilar arterial insufficiency and the subclavian steal syndrome. To explain this phenomenon, it was theorized that instead of thrombosis, healing, and closure of the ductus soon after birth, the thrombus is propagated into the lumen of the aorta, attracts more clot, atheromatous material, and eventually causes premature thrombotic occlusive disease of the aortic arch and descending aorta.

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