CTICasesAortic Coarctation Extra-Anatomic Bypass with Graft-Bronchial Fistula
Imaging findings
CT chest shows an extra-anatomic bypass graft originating from the descending aorta and coursing through the posterior extrapleural space into the abdomen, with adjacent shaggy consolidative opacity and airway thickening, in a patient with aortic coarctation presenting with hemoptysis.
Key takeaways
Extra-anatomic bypass is a treatment reserved for complex or recurrent aortic coarctation. Long-term complications include graft-bronchial or graft-esophageal fistulas, which present with hemoptysis or hematemesis and represent a surgical emergency requiring endovascular or surgical repair.
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