Infarto, tromboembolismo pulmonar y embolia paradojal inminente

Abstract

Endovascular repair of recoarctation was indicated. For strategy optimization, a reconstruction and 3D printing model of the pathological aorta was performed (Figure 1).The procedure was carried out under neuroleptanalgesia, with continuous central monitoring of differential pressure and a rapid pacemaker during stent placement. An AltoSa-XL-Gemini Balloon Catheter of 18 mm diameter and 50 length (AndraTec GmbH, Koblenz, Germany) was used over which a self-expandable covered Andrastent 48XL stent (PTFE-tube covered cobalt-chromium stent with semi-open cell design, AndraMed GmbH, Reutlingen, Germany) was mounted. Once deployed, a control angiography was performed and differential arterial pressures were recorded in pull back. The covered stent was placed in the correct position, and the previous gradient of 60 mmHg was reduced to 15 mmHg (Figure 2).The patient was discharged three days after surgery with no antihypertensive drugs and with normal kidney function. At present, he walks three kilometers a day without claudication.Indications for surgery on a patient with recoarctation are the same as those for the native disease. Those indications include a transcoarctation pressure gradient >20 mmHg, persistent hypertension not attributable to other causes, radiological evidence of clinically significant collateral flow, heart failure associated with coarctation, or disabling intermittent claudication. (2) Although severe anemia may have been the precipitating factor of this patient's symptoms of claudication, management of blood pressure was difficult, as he was taking five antihypertensive drugs.Aneurysm or pseudoaneurysm is usually found distal