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A 45-year-old woman, who had atypical coarctation of the aorta due to aortitis syndrome, underwent ascending-infrarenal abdominal aorta bypass successfully. A woven dacron prosthesis of 14 mm in diameter was anastomosed to the ascending aorta. The course of the graft arranged to pass through a hole cut into the diaphragm across the omental sac behind the pancreas to the infrarenal abdominal aorta. This operation is approached through a midline sternal-splitting and abdominal incision, accordingly pulmonary complication and injury to major collateral vessels associated with lateral thoracotomy can be avoided.
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