Stenting of aortic coarctation before coronary artery bypass surgery in an adult with acute myocardial infarction: a case report

Aortic coarctation is a major risk factor for high blood pressure and atherosclerotic disease development. Evidence is lacking regarding the treatment of acute coronary syndrome in patients with untreated aortic coarctation. A 50-year-old male with a history of hypertension, diabetes, and haemodynamically significant untreated aortic coarctation presented to the emergency department with non-ST-elevation acute myocardial infarction. Coronary catheterization showed severe three-vessel disease. The aortic coarctation was addressed percutaneously using a covered CP stent. A quadruple coronary artery bypass surgery was conducted the following day. He was discharged home ten days after surgery. We describe a successful sequential approach involving the percutaneous repair of a native aortic coarctation followed by a surgical myocardial revascularization in the context of acute coronary syndrome. Discussion within a multidisciplinary Heart Team is key in patients with such complexity.