Hybrid approach for aortic rupture during balloon coarctoplasty

We present a hybrid rescue technique for aortic rupture in a 33-year-old male who underwent balloon coarctoplasty for recoarctation, 16 years after end-to-end anastomosis for repair of coarctation. Following balloon coarctoplasty with stent deployment, the stent had to be redilated due to residual coarctation gradient, during which there was inadvertent aortic rupture and haemodynamic instability. The rupture was recognized quickly, and a balloon was inflated across the stented segment to provide a tamponade effect until definitive control of bleeding was achieved. The left carotid artery was accessed as an emergency through a cut-down, and a covered stent was deployed across the previously placed stent to seal off the perforation in the proximal descending aorta. This hybrid approach was effective and lifesaving in the face of a potentially catastrophic scenario. The patient had an uneventful recovery and continues to do well at 2 years follow-up.