Coral reef aorta

Coral reef aorta

Heavy calcification of visceral part of aorta, extending into its lumen and causing malperfusion of limbs or viscera is known as ‘coral reef aorta’ [1]. It may cause hypertension due to involvement of renal arteries, which was the commonest finding noted in about 44 percent of patients in one series with 70 patients [2]. Intermittent claudication due to lower limb ischemia was noted in a similar number of patients. About a quarter of them had chronic visceral ischemia causing abdominal pain, loose stools and weight loss.

Majority of them underwent aortic reconstruction with thromboendarterectomy in that series. Perioperative mortality was around twelve percent. Same centre published their experience on 80 patients later [3]. The frequency of renal ischemia causing hypertension and intermittent claudication was similar in the updated series. They describe removal of obstruction to renal, mesenteric (superior and inferior) and lower limb arteries. Long term follow up was obtained only in a third of patients, due to mortality and long distance to travel in an elderly population with poor health.

References

1. Belczak SQ, Sincos IR, Aun R, Costa KV, Araujo EA. Coral reef aorta, emergency surgical: case report and literature review. Einstein (Sao Paulo). 2014 Apr;12(2):237-41.
2. Grotemeyer D, Pourhassan S, Rehbein H, Voiculescu A, Reinecke P, Sandmann W. Int J Angiol. 2007 Fall;16(3):98-105.
3. Sagban AT, Grotemeyer D, Rehbein H, Sandmann W, Duran M, Balzer KM, Grabitz K. Occlusive aortic disease as coral reef aorta – experience in 80 cases. Zentralbl Chir. 2010 Oct;135(5):438-44.