The case was a 53-year-old woman. Her blood pressure not often been correctly measured since age 30. Hypertension was pointed out in an annual check-up the previous year, but it was not treated. In March 2009, she had dyspnea and went to a local hospital. A diagnosis of hypertensive heart failure was made and she was transferred to our hospital. Enhanced computed tomography (CT) revealed severe stenosis of the descending aorta at the level of the diaphragm. Atypical aortic coarctation was strongly suspected, and an extra-anatomical bypass was performed to reduce the afterload. The postoperative course was uneventful and she was discharged 22 days after her operation.