Usefulness of endovascular stent-graft for combination with a strict aort coarctation and patent ductus arteriosus for an adult patient: a case report

Abstract

We reported a 21-year-old patient with strict descending aorta coarctation and small post-ductal patent ductus arteriosus, complicated with abortion and hypertension. The patient was successfully treated by endovascular stent-graft with a single cardiac catheterization. Endovascular stent-graft is an easy, safe, and reliable intervention for the treatment of strict descending aorta coarctation and small post-ductal patent ductus arteriosus.

Figure 1

Abnormal mitral valve with congenital elongation and patent ductus arteriosus was shown apical four chamber view (A) and parasternal short axe view (B), respectively.

Figure 2

Thorax CT angiography in anterior posterior (A) and left anterior oblique projections (B), a strict aortic coarctation proximal part of descending aort, ascending aort dilatation, a small size patent ductus arteriosus, and widening and tortuous intercostals artery was detected.

Figure 3

Descending aortography in the lateral projection (A), a patent ductus arteriosus and strict aortic coarctation was showed better than other projection, in the right oblique projection (B) shows widening and tortuous intercostals artery, in anterior posterior projection (C) strict aortic coarctation ascending aort and widening and tortuous intercostals artery was showed, and ascending aortogram in anterior posterior projection (D) shows minimal dilatation ascending aort.

Figure 4

Deployment of stent, firstly (A) the stent-graft was checking for correct position, secondly (B) the inner balloon was inflated, thirdly (C) outer balloon was inflated fully. Control aortography showed that (D), stent-graft in position covering the coarctation segment and complete occlusion of the patent ductus arteriosus was achieved.

Figure 5

Before endovascular graft stent, maximum gradient across the coarctation was 102 mmHg (A), The gradient across the coarctation was decreased and measured as 0 mmHg after the procedure (B).