Development of acute type B aortic dissection in an adult patient with untreated coarctation of the aorta is a rare phenomenon. A 62-year-old man was incidentally found to have coarctation of the aorta when he was suffered a type B aortic dissection. Initially, he was treated medically, but the diameter of the proximal descending aorta was progressively expanding. Descending aorta replacement followed by excision of the coarctation and intimal tear were performed electively. Surgical repair resulted in a good outcome.
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