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Coarctation of Aorta Mimicking Aortic Arch Interruption and its Successful Dilatation by an Innovative Approach

Ramamurthy1, Juneja, Yadave

  • 1Assistant Professor, Department of Cardiology, Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India, 110029.

The Journal of Invasive Cardiology
|September 6, 2000
PubMed

Insights

Balloon dilatation for aortic coarctation is effective. A challenging case with atypical anatomy and suspected aortic arch interruption was successfully treated using antegrade crossing and femoral balloon dilatation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Balloon dilatation is a standard treatment for coarctation of the aorta in children and young adults.
  • Caution is advised for atypical coarctation anatomy involving aortic arch branches.

Purpose of the Study:

  • To report a successful treatment of a complex coarctation case with unusual anatomy.
  • To demonstrate an alternative approach for challenging coarctation interventions.

Main Methods:

  • Descending thoracic aortography revealed suspected aortic arch interruption.
  • Brachial approach and ascending aortography clarified the distorted anatomy.
  • Antegrade crossing of the coarctation was achieved using a snare device.
  • Balloon dilatation was performed via the femoral route.

Main Results:

  • The coarctation segment had a distorted anatomy, mimicking aortic arch interruption.
  • Retrograde crossing was not possible.
  • Antegrade crossing and successful balloon dilatation were achieved.
  • The procedure was performed using a femoral approach.

Conclusions:

  • Complex coarctation with distorted anatomy can be successfully treated with antegrade crossing and balloon dilatation.
  • The brachial approach facilitated diagnosis and antegrade wire access.
  • Femoral balloon dilatation is a viable option for challenging coarctation cases.

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