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Acute aortic occlusion as a late complication of coarctation repair
C R Williams1, V Nilakhe, M E Clouse
1Department of Diagnostic Radiology, New England Deaconess Hospital, Boston, MA 02215.
Insights
Surgical repair of aortic coarctation in adults can lead to late complications. This case highlights a rare Dacron graft dehiscence causing aortic occlusion and pseudoaneurysm.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Adult Congenital Heart Disease
Background:
- Late morbidity after aortic coarctation repair is mainly due to hypertension.
- Complications at the repair site, such as residual coarctation or aneurysm, are uncommon in adults.
Observation:
- An unusual case of Dacron tube graft dehiscence after aortic coarctation repair is presented.
- This dehiscence created a flap-valve effect, leading to pseudoaneurysm and acute aortic occlusion.
Findings:
- The primary cause of late morbidity and mortality is associated cardiovascular disease, particularly hypertension.
- Graft dehiscence is a rare but severe complication, potentially causing acute aortic obstruction.
Implications:
- This case underscores the importance of vigilant long-term follow-up for patients with repaired coarctation of the aorta.
- Understanding rare complications like graft dehiscence is crucial for managing adult patients with complex cardiovascular conditions.
Abstract:
Late morbidity and mortality following surgical correction of coarctation of the aorta in adults are primarily related to associated cardiovascular disease, especially persistent systemic hypertension and its sequelae. complications related to the site of coarctation repair are relatively uncommon in this age group and include residual and recurrent coarctation and aneurysm formation. An unusual case is presented in which dehiscence of the proximal suture line of a Dacron tube graft resulted in a flap-valve effect, pseudoaneurysm formation, and acute functional occlusion of the aorta. The angiographic findings are described and the relevant literature reviewed.