Successful surgical treatment of the supradiaphragmatic middle aortic syndrome by an extra-anatomical bypass in a child.

We report a 5-year-old girl (13kg) was referred to our facility for cardiologic examination due to uncontrolled hypertension and significant heart failure. Chest radiography elevated cardiothoracic ratio of over 60% with rib notching and the absence of an aortic knob. Transthoracic echocardiography showed a dilated left ventricle with a reduced ejection fraction and significant stenosis of the descending aorta with a pressure gradient of 64 mm Hg.