A twenty years old patient, with arterial hypertension at the right arm and absent pulse in both lower extremities was studied by angiography, and a coarctation of aortic arch with partial hypoplasia of aortic arch and aortic isthmus was found. Patient underwent to a surgical operation and, by anterior approach, an ascending thoracic aorta-supraceliac abdominal aorta by-pass was made. In the present case report, advantages, indications and experience with such by-pass modality are review.

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