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. 2018 Apr;6(2):59-64.
doi: 10.1055/s-0038-1669435. Epub 2018 Sep 12.

Therapeutic Alternatives in the Management of Late Complications of Surgery for Isolated Coarctation of the Aorta

Imad Tabry  1 , Michael Rush  1
Affiliations

Therapeutic Alternatives in the Management of Late Complications of Surgery for Isolated Coarctation of the Aorta

Imad Tabry et al. Aorta (Stamford). 2018 Apr.

Abstract

Despite initial technical success in the treatment of coarctation of aorta, late recurrence and/or development of aneurysms and pseudoaneurysms frequently prompt reintervention. The authors hereby present such a patient whose management required more than a single intervention to treat his complex anatomy, and they discuss the therapeutic alternatives under similar circumstances.

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Conflict of interest statement

The authors declare no conflict of interest related to this article.

Figures

Fig. 1
Fig. 1
Computed tomographic findings. Upper panel, lateral view: proximal (upper arrow) and distal (lower arrow) large anastomotic pseudoaneurysms of the left subclavian to aorta bypass graft. Lower panel, frontal view: arrow points to large distal graft pseudoaneurysm.
Fig. 2
Fig. 2
Proximal (upper arrow) and distal (lower arrow) pseudoaneurysms of left subclavian to aorta bypass graft. Occluded right subclavian artery. Bovine origin of carotids. Stenosis of the origin of the left vertebral artery.
Fig. 3
Fig. 3
First-stage surgery: right carotid to subclavian artery bypass graft.
Fig. 4
Fig. 4
Right posterolateral thoracotomy and off-pump anastomosis of distal graft to supradiaphragmatic aorta.
Fig. 5
Fig. 5
Proximal graft anastomosis to ascending aorta.
Fig. 6
Fig. 6
Completed extra-anatomic ascending aorta to descending aorta bypass graft through right thoracotomy and off pump.
Fig. 7
Fig. 7
Upper panel: angiographic finding of the proximal anastomotic pseudoaneurysm (arrow). Lower panel: endovascular stenting of the proximal anastomotic pseudoaneurysm with 16 × 80 mm Medtronic covered stent graft deployed across the origin of the left vertebral artery.
Fig. 8
Fig. 8
Upper panel: angiographic finding of the distal anastomotic pseudoaneurysm (arrow). Lower panel: endovascular stenting of distal anastomotic pseudoaneurysm with 24 × 100 mm long Medtronic stent graft from level of coarctation to the insertion of the ascending-to-descending thoracic aorta bypass graft.
Fig. 9
Fig. 9
Completion angiogram shows a patent extra-anatomic ascending to descending aorta bypass graft (arrow), occluded left subclavian to thoracic aorta bypass graft, and occluded proximal and distal pseudoaneurysms.
See this image and copyright information in PMC

References

    1. Powell W R, Adams P R, Cooley D A. Repair of coarctation of the aorta associated with intracardiac repair. Tex Heart Inst J. 1983;10(04):409–413. - PMC - PubMed
    1. Edie R N, Janani J, Attai L A, Malm J R, Robinson G. Bypass grafts for recurrent or complex coarctations of the aorta. Ann Thorac Surg. 1975;20(05):558–566. - PubMed
    1. Bricknell C, Hamady M. Aneurysmal complications of coarctation. Endovascular Today. 2015:75–78.
    1. Hörer T, Toivola A. Endovascular repair of a ruptured aortic extra-anatomic bypass pseudoaneurysm after previous coarctation surgery. Innovations (Phila) 2015;10(05):370–372. - PubMed
    1. Knyshov G V, Sitar L L, Glagola M D, Atamanyuk M Y. Aortic aneurysms at the site of the repair of coarctation of the aorta: a review of 48 patients. Ann Thorac Surg. 1996;61(03):935–939. - PubMed