Aortic rupture in children and adolescents may be the primary manifestation of coarctation of the aorta of the adult type. Two patients with mycotic aneurysm immediately distal to the coarctation and one with dissecting aneurysm of the ascending aorta are reported. Two of the patients died of hemorrhage—one with mycotic aneurysm during operation, and the other with dissecting aneurysm before operation could be performed. In the remaining patient with a mycotic aneurysm resection and graft of the involved segment was successfully performed with the aid of partial bypass, hypothermia of 29.5 C, and total circulatory arrest for two periods of 22 minutes each. After a prolonged postoperative course complicated by ischemic brain damage, liver abscesses, and an aortic bifurcation aneurysm the patient recovered completely.