Mid-Aortic Syndrome

A 15-yr-old male with ischemic bowel pain and mid-aortic syndrome presented for surgical correction. An aortogram revealed narrowing of the aorta (black arrow) from level celiac artery to origin inferior mesenteric artery. Whereas right renal (dotted branched off narrowed segment aorta, left kidney was supplied entirely collateral vessels axis (white arrows).Mid-aortic is responsible 0.5 2% stenotic lesions present in children young adults.1 Up 85% patients have at a that involves arteries. This chronically compromises blood flow, which leads worsening renovascular hypertension disease. Additionally, up 70% superimposed unilateral or bilateral stenosis.2 Hypovolemia hypotension induced during surgery anesthesia may lead acute already compromised perfusion.Anesthesiologists should consider using invasive pressure monitoring an upper extremity, foley catheter, titrate levels maintain adequate urine output before after aortic cross-clamping. Noninvasive lower extremity can help determine gradient between before, improvement after, repair narrowing.2 Spinal cord protection measures not routinely been used because only 3% high enough cross-clamping will spinal ischemia.2,3The authors declare no competing interests.