Coarctation of the aorta is a common congenital abnormality that may be associated with serious and rare anomalies like aneurysms. Severe coarctation or interrupted aortic arch in adults is usually managed by percutaneous interventions or extra-anatomic bypass. However, the presence of an aneurysm beyond the coarcted segment implies the opening of a collateral-rich segment of the aorta with redressal of the arch if hypoplastic. We describe our experience in managing three such patients through antero-lateral thoracotomy with antegrade cerebral perfusion. We have found this technique helpful in treating aneurysms of the distal aortic arch or proximal descending thoracic aorta.

We present the case of a 62-year old female who presented with dyspnoea caused by severe mitral valve regurgitation. Preoperative evaluation revealed unilateral primary pulmonary hypoplasia of the left lung. Mitral valve plasty was successfully performed without postoperative respiratory complications, using a left antero-axillary thoracotomy approach resulting in excellent exposure of the mitral valve.