Coarctation of the aorta of the adult type I. Complete obliteration of the descending arch at insertion of the ductus in a boy of fourteen; Bicuspid aortic valve; Impending rupture of the aorta; Cerebral death

Concomitant percutaneous treatment of aortic coarctation and associated intercostal aneurysms: pre-procedural recognition is key

“…The abnormal histology has been noted since at least Dr Abbott's time, who described many vessels in coarctation patients as "thin-walled and atheromatous". 9 Subsequent authors have labelled this phenomenon as "cystic medial necrosis", but more recent evidence demonstrated that the underlying arterial histopathology is characterised by depletion and disarray of elastin fibres in the vessel wall. 10,11 Aneurysm formation is possibly related, at least in part, to this loss of structural integrity.…”

“…The following two factors are likely implicated: altered vessel histology and flow dynamics. The abnormal histology has been noted since at least Dr Abbott’s time, who described many vessels in coarctation patients as “thin-walled and atheromatous” 9 . Subsequent authors have labelled this phenomenon as “cystic medial necrosis”, but more recent evidence demonstrated that the underlying arterial histopathology is characterised by depletion and disarray of elastin fibres in the vessel wall 10 …”

“…Aneurysms have numerous, potentially significant deleterious effects. The most obvious is the risk of rupture; the patient described by Leudet was a 37-year-old woman in whom the intercostal eroded into her left main bronchus leading to severe haemoptysis and death 9 . Rupture has also been reported after treatment for coarctation, many years after surgery in one case 20 …”

Elastic Properties of the Descending Aorta in Patients with a Bicuspid or Tricuspid Aortic Valve and Aortic Valvular Disease

“…In Canada during the 1880s Osler [11] noted that BAV was prone to endocarditis [12,13]. At the same institution, Abbot [14] reported a BAV patient with dissection of the ascending aorta in a case with aortic coarctation, an association verified 50 years later in a larger necropsy study [15]. Today, we know that a majority of patients undergoing aortic valve replacement have BAV [16].…”