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- Title
LATE POSTOPERATIVE COMPLICATION AFTER SURGICAL CORRECTION OF COARCTATION OF AORTA. THERAPEUTIC CONSEQUENCES - CASE REPORT.
- Authors
Mandeş, L. A.; Beladan, Carmen; Popescu, B. A.; Rădulescu, B.; Lacau, Smarandita; Ginghina, Carmen
- Abstract
Coarctation of aorta (CoA) is a narrowing of the aorta localized distal to the origin of the left subclavian artery, and is five times more frequent in males versus females. In about 30 to 85 percent of patients, CoA is associated with bicuspid aortic valve (BAV), and might represent an expression of the same disease.A 34-year-old male with a history of corrective surgery for CoA and systemic hypertension was admitted to our hospital for atypical chest pain. Physical examination revealed systemic hypertension. Chest x-ray demonstrated enlargement of the mediastinum, and ECG was suggestive for left ventricular hypertrophy. 2-D transthoracic echocardiography was consistent with moderate concentricleft ventricular hypertrophy and ascending aorta dilation. Transesophageal echocardiography showed a normally functioning bicuspid aortic valve. AngioCT scan confirmed the aortic aneurysm (58 mm).After admission, treatment was initiated to adequately control the blood pressure. Subsequently, we opted for surgical correction of the aortic aneurysm with a supracoronary aortic graft, preserving the native aortic valve. Postoperative evolution was favorable, with good long-term prognosis after surgery. Patients with repaired CoA suffer from excess morbidity and mortality due to late complications. Both BAV and CoA are associated with ascending aorta dilation, with a synergic increase in risk for aneurysm dissection and progression. The present case illustrates the association of BAV with CoA as a possible etiology for the ascending aorta aneurysm formation, and the difficulties in choosing the "right" surgical approach. Moreover, we emphasize the need for active screening for possible complications in patients with corrected CoA.
- Subjects
AORTIC diseases; SURGICAL complications; SURGERY
- Publication
Romanian Journal of Functional & Clinical, Macro & Microscopical Anatomy & of Anthropology / Revista Româna de Anatomie Functionala si Clinica, Macro si Microscopica si de Antropologie, 2015, Vol 14, Issue 3, p528
- ISSN
1583-4026
- Publication type
Article