Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta
Introduction: A late aortic aneurysm at the site of previous open surgery for coarctation of the aorta (CoA) is a life threatening complication. Several strategies have been reported, however, these strategies have issues. This is the report of a case involving successful ascending to descending aor...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | EJVES Vascular Forum |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666688X20300101 |
| _version_ | 1819074883748888576 |
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| author | Takeshi Kamada Ryoichi Tanaka Tomoyuki Iwase Kotaro Oyama Hajime Kin |
| author_facet | Takeshi Kamada Ryoichi Tanaka Tomoyuki Iwase Kotaro Oyama Hajime Kin |
| author_sort | Takeshi Kamada |
| collection | DOAJ |
| description | Introduction: A late aortic aneurysm at the site of previous open surgery for coarctation of the aorta (CoA) is a life threatening complication. Several strategies have been reported, however, these strategies have issues. This is the report of a case involving successful ascending to descending aortic bypass concomitant with endovascular embolisation for a pseudoaneurysm. Report: The patient was a 23 year old man with a history of patch aortoplasty for coarctation of the aorta (CoA) via a left thoracotomy and patch closure of a ventricular septal defect. Enhanced computed tomography (CT) angiography performed in 2014 revealed a pseudoaneurysm at the site of the previous patch aortoplasty. CT also revealed a hypoplastic and severely kinked aortic arch that made it difficult to perform conventional thoracic endovascular aortic repair for this aneurysm. Therefore in order to prevent rupture, a combination of ascending to descending aortic bypass and endovascular embolisation using Amplatzer vascular plugs and coils was employed. Transection of the aortic arch and transposition of the left subclavian artery were performed to prevent antegrade flow into the aneurysm. Discussion: The aneurysm was successfully excluded without complications. CT performed three years after the operation showed that the pseudoaneurysm had shrunk completely. Extra-anatomic bypass concomitant with endovascular embolisation for a late coarctation patched site aneurysm might be an alternative strategy that should be carefully considered in specific cases. |
| first_indexed | 2024-12-21T18:16:36Z |
| format | Article |
| id | doaj.art-8c17f705f38241bc9b2de6861db0896f |
| institution | Directory Open Access Journal |
| issn | 2666-688X |
| language | English |
| last_indexed | 2024-12-21T18:16:36Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJVES Vascular Forum |
| spelling | doaj.art-8c17f705f38241bc9b2de6861db0896f2022-12-21T18:54:39ZengElsevierEJVES Vascular Forum2666-688X2020-01-01472225Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the AortaTakeshi Kamada0Ryoichi Tanaka1Tomoyuki Iwase2Kotaro Oyama3Hajime Kin4Department of Cardiovascular Surgery, Iwate Medical University, Iwate, Japan; Corresponding author. Department of Cardiovascular Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.Department of Radiology, Iwate Medical University, Iwate, JapanDepartment of Cardiovascular Surgery, Iwate Medical University, Iwate, JapanDepartment of Pediatric Cardiology, Iwate Medical University, Iwate, JapanDepartment of Cardiovascular Surgery, Iwate Medical University, Iwate, JapanIntroduction: A late aortic aneurysm at the site of previous open surgery for coarctation of the aorta (CoA) is a life threatening complication. Several strategies have been reported, however, these strategies have issues. This is the report of a case involving successful ascending to descending aortic bypass concomitant with endovascular embolisation for a pseudoaneurysm. Report: The patient was a 23 year old man with a history of patch aortoplasty for coarctation of the aorta (CoA) via a left thoracotomy and patch closure of a ventricular septal defect. Enhanced computed tomography (CT) angiography performed in 2014 revealed a pseudoaneurysm at the site of the previous patch aortoplasty. CT also revealed a hypoplastic and severely kinked aortic arch that made it difficult to perform conventional thoracic endovascular aortic repair for this aneurysm. Therefore in order to prevent rupture, a combination of ascending to descending aortic bypass and endovascular embolisation using Amplatzer vascular plugs and coils was employed. Transection of the aortic arch and transposition of the left subclavian artery were performed to prevent antegrade flow into the aneurysm. Discussion: The aneurysm was successfully excluded without complications. CT performed three years after the operation showed that the pseudoaneurysm had shrunk completely. Extra-anatomic bypass concomitant with endovascular embolisation for a late coarctation patched site aneurysm might be an alternative strategy that should be carefully considered in specific cases.http://www.sciencedirect.com/science/article/pii/S2666688X20300101Ascending to descending aortic bypassCoarctation of the aortaEndovascular embolisationOpen surgeryPseudoaneurysm |
| spellingShingle | Takeshi Kamada Ryoichi Tanaka Tomoyuki Iwase Kotaro Oyama Hajime Kin Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta EJVES Vascular Forum Ascending to descending aortic bypass Coarctation of the aorta Endovascular embolisation Open surgery Pseudoaneurysm |
| title | Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta |
| title_full | Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta |
| title_fullStr | Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta |
| title_full_unstemmed | Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta |
| title_short | Successful Ascending to Descending Aortic Bypass and Endovascular Embolisation of a Late Pseudoaneurysm Following Patch Aortoplasty for Coarctation of the Aorta |
| title_sort | successful ascending to descending aortic bypass and endovascular embolisation of a late pseudoaneurysm following patch aortoplasty for coarctation of the aorta |
| topic | Ascending to descending aortic bypass Coarctation of the aorta Endovascular embolisation Open surgery Pseudoaneurysm |
| url | http://www.sciencedirect.com/science/article/pii/S2666688X20300101 |
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