Abstract
We present a dramatic case of coarctation of the descending aorta. Standard surgical treatment led to graft infection, necessitating a complex series of additional surgical procedures-all without resolution. A classical "thromboexclusion" procedure accomplished durable, decades-long survival. The thromboexclusion produced the expected thrombotic occlusion of the descending aorta. The extra-anatomic ascending-to-abdominal bypass graft provided long-term blood flow to the abdominal organs and lower extremities.