{
  "abstract": "Background: Hypoplastic arch and residual coarctation are treated with ascending to descending extra-anatomic bypasses and are challenging to manage.\n\nCase Summary: A 36-year-old woman with several sternotomies had undergone ascending to descending extra-anatomic bypass as a neonate. She experienced blunt force trauma to her chest, and significant delay in diagnosis led to decompensation. A nondisplaced fracture lacerated the aortic graft and led to a contained rupture and bacteremia. She underwent left thoracotomy and complex thoracic endovascular aortic repair. Six weeks of antibiotics and careful conservative management led to a safe outcome.\n\nDiscussion: Management of a ruptured extra-anatomic bypass in the setting of bacteremia with thoracic endovascular aortic repair is controversial. Given multiple prior sternotomies, the degree of required tissue debridement, and anticipated lifelong antibiotic suppression, an initial endovascular approach seemed warranted. Unconventional approaches to complex adult congenital heart disease (ACHD) lesions are necessary to increase longevity and mitigate disease.\n\nTake-Home Messages: Patients with ACHD require early recognition with a high index of suspicion. Endovascular repair in ACHD arch pathology should be considered.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA",
    "Division of Vascular Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA",
    "Division of Cardiac Anesthesia, Department of Anesthesia, Oregon Health and Science University, Portland, Oregon, USA"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nikita Zadneulitca"
    },
    {
      "affs": [
        1
      ],
      "name": "Bryant Mclafferty"
    },
    {
      "affs": [
        0
      ],
      "name": "Brent Demanby"
    },
    {
      "affs": [
        2
      ],
      "name": "Nicholas C. Eglitis"
    },
    {
      "affs": [
        1
      ],
      "name": "Rhusheet P. Patel"
    },
    {
      "affs": [
        0
      ],
      "name": "Castigliano M. Bhamidipati"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4v91ef8r43knv.bib",
  "cited_by": 1,
  "doi": "10.1016/j.jaccas.2026.110034",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699042/",
  "id": "4v91ef8r43knv",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.110034",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Case"
    ],
    [
      "heading",
      "Congenital Heart Disease"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2740|Aortic Disease and Treatment Approaches"
    ]
  ],
  "openalex": "W7204542483",
  "pdf_url": null,
  "pmcid": "PMC13699042",
  "pmid": "42663349",
  "published": "2026-08-28",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/4v91ef8r43knv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:43Z",
      "native_id": "PMC13699042",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.110034"
    },
    {
      "first_seen": "2026-10-30T13:43:15Z",
      "native_id": "9de47c2e7614415ebedac81da2e72a0c",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.jaccas.2026.110034"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Endoarch Repair of Ruptured Extra-Anatomic Ascending to Descending Bypass Graft in Hypoplastic Arch With Coarctation",
  "title_text": "Endoarch Repair of Ruptured Extra-Anatomic Ascending to Descending Bypass Graft in Hypoplastic Arch With Coarctation",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:15Z",
  "url": "https://research.draconitic.com/paper/4v91ef8r43knv",
  "venue": "JACC Case Reports",
  "versions": []
}