Endovascular Covered Stent Treatment for Descending Aorta Pseudoaneurysm Following Coarctation of the Aorta Repair in an Infant

Abstract

The development of a pseudoaneurysm is a rare complication following repair of a coarctation of the aorta. Surgical management of pseudoaneurysms is associated with high morbidity and mortality. We describe the successful endovascular deployment of a covered stent in a sick infant with a descending aorta pseudoaneurysm, following the repair of an aortic coarctation. We highlight the challenges we encountered. Endovascular repair is a safe palliative alternative to re-do open surgery in unstable infants with large pseudoaneurysms following aortic coarctation repair. The role of endovascular stents as the final definitive therapy will remain limited by the deployable, small-size stents in small, growing children.(Heart, Lung and Circulation 2010;xxx:1-4)

Pseudoaneurysm and aorto-bronchial fistula following balloon dilation of recoarctation

“…Displacement or lysis of the thrombus may result in recurrent and often fatal, massive re-bleeding. Open surgery is the procedure of choice for pseudoaneurysms complicated by aorto-bronchial haemorrhage, although there are successful case reports treated by implantation of an endovascular stent graft 4 5 We chose a more definitive single-stage surgical correction of the pseudoaneurysm and the aorto-bronchial fistula that allowed complete excision of the pathology and promoted an uncomplicated post-operative course.…”