Stanford type B aortic dissection in an elderly patient with silent aortic coarctation

Although uncomplicated type B dissection is well established to be treated conservatively, adult aortic coarctation is still considered a surgical candidate in the presence of peak-to-peak coarctation gradient >20 mmHg. The treatment for aortic coarctation included surgical repair, balloon angioplasty, and stenting [17]. While balloon angioplasty is the preferred treatment for discrete coarctation in infants and children between 4 months and 5 years of age (<25 kg), stenting is the first choice for larger patients (>25 kg). In the presence of complex coarctation anatomy such as arch hypoplasia, the decision to use balloon angioplasty or stenting versus surgical approach is made on a case-by-case basis. However, for the elderly concerning about the tissue integrity of the paracoarctation region with subsequent risk from complications of interventions, continued medical therapy with goal Images in Clinical Medicine