Middle aortic syndrome treated by stent implantation

Brzezińska‐Rajszys, Grażyna; Qureshi, Shakeel A.; Ksiazyk, J; Zubrzycka, Maria; Kościesza, Andrzej; K, Kubicka; Tynan, Michael

doi:10.1136/hrt.81.2.166

Cited by 48 publications

(24 citation statements)

References 22 publications

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“…Patient characteristics, management and outcome of our six cases and 96 cases from the literature [1][2][3][4][5][6][7][8][9][10][11][12][14][15][16] are shown in Tables 2 and 3.…”

Section: Resultsmentioning

confidence: 99%

“…Patch aortoplasty, 10% of cases, is best for short-segment stenoses [6] and for very young patients, which leaves the possibility of bypass at an older age [5]. Other interventions, such as percutaneous transluminal balloon angioplasty and stent placement, have not had long-term success, and many complications are reported [5,12]. For renal artery stenosis, autotransplantation or aorto-renal bypass with autogenous vessels or prosthetic graft is preferred [5].…”

Section: Discussionmentioning

confidence: 99%

“…There are reports on the surgical management of MAS [1][2][3][4][5][6][7][8][9][10][11][12], but there have been few case reports in recent years and even fewer in the pediatric literature that describe the diagnostic and medical management of MAS. Furthermore, prior case series grouped MAS together with varying etiologies, while this report focuses specifically on idiopathic MAS.…”

Section: Introductionmentioning

confidence: 99%

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Idiopathic mid-aortic syndrome in children

et al. 2008

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Mid-aortic syndrome (MAS) is an uncommon condition characterized by narrowing of the abdominal aorta and stenosis of its major branches. Our goal was to illustrate the presentation, diagnosis and management of six new cases of idiopathic MAS together with 96 cases of idiopathic MAS from the literature. The mean age of the 102 cases was 14.3 years (19 days to 49 years). Our patient who presented at 19 days of age is the youngest reported to date. Clinical presentations included hypertension (94%), claudication (17%), renal failure (4%) and intestinal ischemia (1%). Angiography was the diagnostic imaging study of choice. Renal arteries were involved in 91% of patients, while the superior mesenteric artery and celiac artery were involved in 35%. Thirteen percent of cases were managed medically, and the remainder was treated surgically. Our experience shows that initial conservative blood pressure management of idiopathic MAS is feasible unless medical control of hypertension is unsatisfactory, renal function is at risk or there are symptoms of claudication or intestinal ischemia. Careful timing and planning of a surgical intervention is possible for most cases and may, in select cases, be considered after completion of puberty to allow growth to be completed.

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“…Patient characteristics, management and outcome of our six cases and 96 cases from the literature [1][2][3][4][5][6][7][8][9][10][11][12][14][15][16] are shown in Tables 2 and 3.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Idiopathic mid-aortic syndrome in children

et al. 2008

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“…In patients after invasive treatment (surgical or endovascular) of CoA in whom AH is still present or developed after period of normotension, ABPM should be regularly done to assess treatment efficacy. According to the recommendations of both AHA and ESC, the assessment of postoperative anatomy of the aorta, including aortic arch configuration, as factors affecting the recurrence and severity of AH, requires periodic imaging examinations (depending on age ECHO, CT, MRI patient), performed usually every few years [78,79]. In patients with coarctation of the aorta and coexistence of a bicuspid aortic valve, the monitoring must additionally include the evaluation of anatomy and potential aortic valve dysfunction and the degree of ascending aorta dilatation.…”

Section: Treatment Of Hypertension In Children After Surgical Treatmementioning

confidence: 99%

Zalecenia Sekcji Pediatrycznej Polskiego Towarzystwa Nadciśnienia Tętniczego dotyczące postępowania diagnostycznego i terapeutycznego w nadciśnieniu tętniczym u dzieci i młodzieży

Litwin

Niemirska

Obrycki

et al. 2018

Arterial Hypertension

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Presented recommendations are an extended and actualized version of paediatric recommendations of Polish Society of Hypertension published in 2015. Since then, new studies have appeared on this subject, introducing a new classification of hypertension, newly described principles of management in risk groups and methods of assessing hypertensive target organ damage. The presented updated recommendations included changes introduced in the 2016 European Society of Hypertension recommendations and Recommendations of Children's Memorial Health Institute in Warsaw. Recently published guidelines of American Academy of Pediatrics have been discussed. In the presented issue of guidelines, epidemiological information on the occurrence and incidence of hypertension in developmental age was added and classification of blood pressure values was updated. Subchapters on diagnosis and organ damage assessment, principles of diagnosis and treatment of hypertension in children with diabetes, chronic kidney disease and a subsection discussing diagnostic and therapeutic difficulties with setting blood pressure targets were revised. In addition, the principles of early diagnosis of arterial hypertension in post-hospital care in children born before 33 weeks of gestation published in 2018 as recommendations of the Polish Neonatal Society have been also taken into account.

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“…4) In this case, it had the possibility that atherosclerosis was the cause because she had hypertension and was ex-smoker. Although she had no history of fever or vascular pain, the difference of blood pressure between both arms in her 40's and the calcification in the first branch of the aorta, including the orifice of the right brachiocephalic and left subclavian arteries, indicated the other possibility that she had TA.…”

Section: Discussionmentioning

confidence: 91%

Axillofemoral Bypass Markedly Improved Acute Decompensated Heart Failure and Kidney Injury in a Patient with Severely Calcified Stenosis of Thoracoabdominal Aorta (Atypical Aortic Coarctation)

et al. 2017

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SummaryAtypical aortic coarctation (AAC) has been reported to occur anywhere along the aorta, except for the ascending aorta. The associated symptoms include hypotension in the lower half of the body, secondary hypertension in the upper half of the body, and heart failure. Here we present an 80-year-old Asian woman complaining of progressive exertional dyspnea. She was diagnosed with acute decompensated heart failure and kidney injury due to severely calcified stenosis of the thoracoabdominal aorta, the so called AAC. She received hemodiafiltration, and pulmonary congestion improved in part. Generally, surgical treatments are quite invasive in elderly patients. Endovascular stent graft placement is less invasive, however, fracture and rupture should be considered at severely calcified lesions like this case. Therefore, we selected extra-anatomical axillofemoral bypass. Her recovery after the surgery was remarkable. In a few days, she became free from hemodiafiltration, intravenous diuretics, and oxygen administration. We thought the contributive factors are the increase in kidney blood flow and the correction of afterload mismatch. The decrease in pulse pressure may reflect the reduction in systemic arterial compliance by axillofemoral bypass. The operative mortality of axillofemoral bypass was reported to be acceptable, although the patency of the axillofemoral bypass graft was not high enough. In conclusion, axillofemoral bypass is effective and feasible for elderly patients with acute decompensated heart failure and kidney injury due to AAC.(Int Heart J 2017; 58: 820-823)

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Middle aortic syndrome treated by stent implantation

Cited by 48 publications

References 22 publications

Idiopathic mid-aortic syndrome in children

Idiopathic mid-aortic syndrome in children

Zalecenia Sekcji Pediatrycznej Polskiego Towarzystwa Nadciśnienia Tętniczego dotyczące postępowania diagnostycznego i terapeutycznego w nadciśnieniu tętniczym u dzieci i młodzieży

Axillofemoral Bypass Markedly Improved Acute Decompensated Heart Failure and Kidney Injury in a Patient with Severely Calcified Stenosis of Thoracoabdominal Aorta (Atypical Aortic Coarctation)

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