Single-Stage Repair of Acute Type A Aortic Dissection Associated With Aortic Coarctation, Perimembranous Ventricular Septal Defect, and Bicuspid Aortic Valve

A 17-year-old man with coarctation of the thoracic aorta, bicuspid aortic valve, perimembranous ventricular septal defect, and acute type A dissection of the ascending aorta underwent emergency repair for dissection by means of single-stage replacement of not only the aortic valve and ascending aorta, but also simultaneous repair of the coarctation by graft interposition. These combined conditions comprised some difficulties that included decisions on the optimal timing and sequence of surgical repair, technique, and circulatory support.