Gunshot wound of the aortic arch and esophagus: unusual indication for ascending-to-abdominal aortic bypass graft.

Repair of a gunshot wound of the aortic arch produced severe "coarctation" of the aorta at the origin of the left subclavian artery, requiring the placement of an ascending-to-abdominal aortic bypass graft. This produced an acceptable hemodynamic result, although 10 days later the patient died of infection caused by a concomitant injury of the esophagus. The operative approach for repair of complex injuries of the intrathoracic great vessels can be improved by experience with multiple approaches to elective repair of thoracic vessels.