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Thromboatheromatous coarctation of the aorta diagnosed with intraoperative TOE during emergent open aneurysm clipping
  1. John S McNeil,
  2. Amanda M Kleiman,
  3. Edward C Nemergut,
  4. Julie L Huffmyer
  1. Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
  1. Correspondence to Dr John S McNeil, jsm6j{at}


A woman in her 50s presenting for emergent intracranial surgery was discovered to have a large incongruity in blood pressure between her right arm and her other extremities. Intraoperative rescue transoesophageal echocardiography (TOE) revealed a large thromboatheromatous burden in her descending aorta resulting in a functional coarctation. Usually diagnosed via CT imaging, we present what we believe to be the first published case diagnosed intraoperatively using TOE. After the diagnosis was made, blood pressure goals were adjusted to provide sufficient perfusion distally and her surgery was completed otherwise uneventfully.

  • stroke
  • vascular surgery
  • neurosurgery
  • anaesthesia
  • hypertension
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  • Contributors All authors provided intraoperative care and created and revised the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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