A Large Calcified Saccular Aneurysm in a Patient with Aortic Coarctation

Çelik, Turgay; İyisoy, Atila; Kurşaklıoğlu, Hürkan; Ünlü, Murat; Köse, Sedat; Özmen, Namık; Işık, Ersoy

doi:10.1007/s10554-005-7190-8

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…Inflammation of the aortic wall, congenital weakness of the aortic arterial wall, or asymmetric and enhanced shear stress may play a significant role in the development of aneurysm formation. [ 1 , 2 ] In the present case, the formation of the calcified biloculated aneurysm just distal to the coarctation may be associated with the relatively advanced age and the bifurcate structure composed of LSA and descending aorta. We believe that the upper portion of the aneurysm is the dilated LSA and the lower portion is the dilated descending aorta.…”

Section: Discussionmentioning

confidence: 61%

“…Coarctation of the aorta may occur anywhere along the descending aorta and more than 95% of the cases; it is located below the origin of the LSA and may involve the origin of this vessel. [ 1 ] Aneurysm may develop distal to the coarctation in patients without any intervention and is associated with significant risk of aortic rupture. Inflammation of the aortic wall, congenital weakness of the aortic arterial wall, or asymmetric and enhanced shear stress may play a significant role in the development of aneurysm formation.…”

Section: Discussionmentioning

confidence: 99%

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Two-stage hybrid treatment strategy for an adult patient with aortic arch coarctation, poststenotic aneurysm, and hypoplastic left subclavian artery

Chen²,

Chen³

et al. 2017

Medicine

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Rationale:Coarctation of aorta in adulthood is usually complicated by other cardiovascular anomalies, posing great technical challenge for intervention.Patient concerns:Here, we report an extremely rare case of aortic arch coarctation combined with a poststenotic biloculated calcified aneurysm and hypoplastic left subclavian artery.Interventions:First, an extra-anatomic bypass was established, along with narrowing of aorta just proximal and distal to the aneurysm. While the bypass graft significantly relieved trans-coarctation gradient, the latter procedure decreased intra-aneurysm pressure and created landing zones for aneurysm occlusion. Six months later, 2 muscular ventricular septal defect occluders were deployed at the proximal and distal orifice of the aneurysm.Outcomes:Follow-up computed tomography angiography confirmed the absence of contrast leakage into aneurysm.Conclusions:A 2-stage hybrid approach described here appears to be feasible, safe, and associated with favorable clinical outcomes in the treatment of complicated aortic coarctation and poststenotic aneurysm.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Two-stage hybrid treatment strategy for an adult patient with aortic arch coarctation, poststenotic aneurysm, and hypoplastic left subclavian artery

Chen²,

Chen³

et al. 2017

Medicine

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“…Although rarely seen, aortic wall pathology such as aneurysm formation, aortic dissection and rupture are mainly the presenting symptoms of adult CoA. When pediatric age group is concerned, the saccular aortic aneurysms distal to coarcted segment are very rare and data about these patients are only confined to limited case reports [5] . Our case report seems to be the youngest patient in literature with this pathology.…”

Section: Discussionmentioning

confidence: 99%

Saccular Aneurysm Formation of the Descending Aorta Associated with Aortic Coarctation in an Infant

Özyüksel¹,

Cantürk²,

Dindar³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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Aneurysm of the descending aorta associated with CoA is an extremely rare congenital abnormality. In this report, we present a 16 months old female patient in whom cardiac catheterization had been performed which had revealed a segment of coarctation and saccular aneurysm in the descending aorta. The patient was operated and a 3x2 centimeters aneurysm which embraces the coarcted segment in descending aorta was resected. In summary, we present a case of saccular aortic aneurysm distal to aortic coarctation in an infant without any history of intervention or vascular inflammatory disease. Our case report seems to be the youngest patient in literature with this pathology.

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“…Although the development of aneurysms proximal to the coarctation site might be expected, aneurysms may occur distal to the coarctation site, which is secondary to the turbulent flow in the region of the coarctation (15). The primary cause of death in unrepaired cases of coarctation of the aorta is aortic rupture; the location of the rupture is usually the ascending aorta (16). Although definitive diagnosis of structural aortic complications in coarctation of the aorta has traditionally rested on conventional angiography, MDCT, increasingly used a first-line investigation, can reliably display aortic complications including aneurysm formation and dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Although definitive diagnosis of structural aortic complications in coarctation of the aorta has traditionally rested on conventional angiography, MDCT, increasingly used a first-line investigation, can reliably display aortic complications including aneurysm formation and dissection. It allows not only an exact definition of size and shape of the aneurysm and its spatial relations to the branch vessels, but also assessment of extravasated blood in acute or subacute rupture (16).…”

Section: Discussionmentioning

confidence: 99%

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

Türkvatan¹,

Akdur²,

Ölçer³

et al. 2009

Diagn Interv Radiol

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Coarctation of the aorta is a congenital malformation and typically a disease of childhood and early adulthood, and there is a reduced life expectancy in patients who have not undergone correction. Without correction, the mean life expectancy of patients with coarctation of the aorta is 35 years, and 90% of untreated patients die before reaching the age of 50 years (1). Hypertensive vascular complications, cerebrovascular hemorrhages, aortic valve destruction, premature coronary artery disease, and aortic aneurysms are seen in patients with unrepaired coarctation of the aorta. In addition, dissection or rupture of the aorta is a life-threatening complication of coarctation of the aorta (2). Although the diagnosis of coarctation of the aorta can usually be made on clinical grounds, imaging is necessary to evaluate the exact anatomy of the lesion and to detect associated abnormalities. Recently, multidetector computed tomographic (MDCT) angiography has become a principal imaging modality for the evaluation of thoracic vascular anomalies because of its short acquisition time and high spatial resolution (3). MDCT angiography with multiplanar and three-dimensional techniques is the noninvasive method of choice for assessing the morphology of coarctation of the aorta, particularly to characterize the location, degree, and length of the narrowing; presence of collateral circulation; relationship to the left subclavian artery; and associated cardiovascular abnormalities. It is important to have accurate information about each of these parameters to devise surgical or interventional repair (4, 5).The aim of this study was to evaluate the reliability of 16-slice MDCT angiography for the preoperative morphologic assessment of coarctation of the aorta in adult patients. Materials and methodsTwenty-four adult patients (17 males and 7 females; median age, 31 years; range, 18-53 years) with clinical suspicion of coarctation of the aorta because of blood pressure gradient in the extremities and weak femoral pulses, who underwent both Doppler echocardiography and MDCT angiography, were included in this study. The symptoms of the patients were dyspnea on exertion (n = 7), chest pain (n = 6), leg weakness on exertion (n = 6), palpitation (n = 2), headache (n = 2), and epistaxis (n = 1). All MDCT images were evaluated for the site, degree and length of the coarctation; the presence of additional cardiac defects, such as patent ductus arteriosus and atrial or ventricular septal defect; and associated vascular anomalies such as an aberrant subclavian artery. The presence of an associated aneurysm and dissection of the thoracic aorta was assessed. The origin, visibility, and course of collateral vessels were also evaluated. Coarctation of the aorta was defined as greater than 25% decrease in vessel diameter. The degree of stenosis was considered severe if the ratio of the coarctation diameter to the distal descending aortic diameter was less MATERIALS AND METHODS Twenty-four adult patients with clinical suspicion of coarctation of the...

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A Large Calcified Saccular Aneurysm in a Patient with Aortic Coarctation

Cited by 10 publications

References 11 publications

Two-stage hybrid treatment strategy for an adult patient with aortic arch coarctation, poststenotic aneurysm, and hypoplastic left subclavian artery

Two-stage hybrid treatment strategy for an adult patient with aortic arch coarctation, poststenotic aneurysm, and hypoplastic left subclavian artery

Saccular Aneurysm Formation of the Descending Aorta Associated with Aortic Coarctation in an Infant

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

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