{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:47:06Z","timestamp":1791906426750,"version":"4.3.4"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":88,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370353"],"award-info":[{"award-number":["82370353"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Interrupted aortic arch (IAA) is a severe congenital anomaly typically fatal in infancy without surgical intervention. Adult presentation of isolated IAA is exceedingly rare and usually relies on an extensive compensatory collateral vascular network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We present the case of a 25-year-old man who presented with malignant hypertension. Computed tomography angiography with 3D reconstruction revealed complete occlusion of the aortic arch distal to the left subclavian artery, accompanied by a massive collateral circulation derived from dilated intercostal and internal mammary arteries. Open surgical repair was performed via a left posterolateral thoracotomy. Intraoperative findings identified an atretic fibrous cord at the occlusion site, suggesting an extreme progression of severe coarctation of the aorta into an acquired interruption. An 18-mm Dacron tube graft was successfully interposed between the arch and descending aorta. Crucially, this was performed as an off-pump extra-anatomic bypass without cardiopulmonary bypass. The postoperative course was uneventful. At 4 months, his blood pressure was significantly improved, though a small residual gradient persisted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that severe coarctation can progress to an acquired atresia mimicking IAA. Off-pump extra-anatomic bypass is a safe and effective strategy expected to alleviate refractory hypertension and prevent long-term cardiovascular and cerebrovascular complications in heavily collateralized adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04600-0","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:05:58Z","timestamp":1784307958000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of an acquired aortic interruption suspected from severe aortic coarctation in an adult with massive collaterals"],"prefix":"10.1186","volume":"21","author":[{"given":"Min","family":"Qiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyi","family":"Hui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qikun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shusheng","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hujun","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"issue":"10","key":"4600_CR1","doi-asserted-by":"publisher","first-page":"1970","DOI":"10.1161\/HYPERTENSIONAHA.123.19454","volume":"80","author":"KB Salciccioli","year":"2023","unstructured":"Salciccioli KB, Zachariah JP. Coarctation of the Aorta: Modern Paradigms Across the Lifespan. Hypertension. 2023;80(10):1970\u20139.","journal-title":"Hypertension"},{"issue":"7","key":"4600_CR2","doi-asserted-by":"publisher","first-page":"2467","DOI":"10.1111\/jocs.15525","volume":"36","author":"Y Jiang","year":"2021","unstructured":"Jiang Y, Wang C, Jiang X, Chen S. Is surgery necessary for adults with isolated interrupted aortic arch? Case series with literature review. J Card Surg. 2021;36(7):2467\u201375.","journal-title":"J Card Surg"},{"issue":"3","key":"4600_CR3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.radcr.2015.06.001","volume":"10","author":"DM Patel","year":"2015","unstructured":"Patel DM, Maldjian PD, Lovoulos C. Interrupted aortic arch with post-interruption aneurysm and bicuspid aortic valve in an adult: a case report and literature review. Radiol case Rep. 2015;10(3):5\u20138.","journal-title":"Radiol case Rep"},{"issue":"2","key":"4600_CR4","first-page":"118","volume":"29","author":"G Messner","year":"2002","unstructured":"Messner G, Reul GJ, Flamm SD, Gregoric ID, Opfermann UT. Interrupted aortic arch in an adult single-stage extra-anatomic repair. Tex Heart Inst J. 2002;29(2):118\u201321.","journal-title":"Tex Heart Inst J"},{"issue":"23","key":"4600_CR5","first-page":"e714","volume":"118","author":"CA Warnes","year":"2008","unstructured":"Warnes CA, Williams RG, Bashore TM, et al. ACC\/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease. Circulation. 2008;118(23):e714\u2013833.","journal-title":"Circulation"},{"issue":"2","key":"4600_CR6","first-page":"147","volume":"32","author":"C Sai Krishna","year":"2005","unstructured":"Sai Krishna C, Bhan A, Sharma S, Kiran U, Venugopal P. Interruption of aortic arch in adults: surgical experience with extra-anatomic bypass. Tex Heart Inst J. 2005;32(2):147\u201350.","journal-title":"Tex Heart Inst J"},{"issue":"10","key":"4600_CR7","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1111\/jocs.14173","volume":"34","author":"C Garcia","year":"2019","unstructured":"Garcia C, Rey J, Lopez A, Lamelas J, Orozco-Sevilla V. Left subclavian to descending aorta bypass: A less invasive extra-anatomical solution for a type A interrupted aortic arch. J Card Surg. 2019;34(10):1117\u20139.","journal-title":"J Card Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-026-04600-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04600-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04600-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:07:10Z","timestamp":1791904030000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13019-026-04600-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4600"],"URL":"https:\/\/doi.org\/10.1186\/s13019-026-04600-0","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]},"assertion":[{"value":"4 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"771"}}