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Retrograde percutaneous repair of aortic coarctation utilizing trans-septal puncture in patients with complex anatomy
Jacob A Misenheimer1, Paul Poommipanit1, Zahid Amin1
1Division of Congenital and Structural Heart Disease, Georgia Regents University, Augusta, Georgia.
Insights
Trans-septal approach offers a novel solution for treating complex coarctation of the aorta (COA) when traditional methods fail. This technique enables successful stenting in challenging COA cases, avoiding surgery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Coarctation of the aorta (COA) is a common congenital heart defect.
- Percutaneous treatment of COA can be difficult due to complex vascular anatomy.
Observation:
- Two cases of COA with complex anatomy presented challenges for traditional femoral and radial approaches.
- A trans-septal approach was utilized to cross the COA lesion anterograde.
Findings:
- The trans-septal approach facilitated retrograde stenting of the COA lesions after wire externalization.
- This technique proved effective in complex COA cases where standard approaches failed.
Implications:
- The trans-septal approach provides a viable alternative for percutaneous COA intervention in complex anatomies.
- This method can help avoid surgical intervention for challenging COA cases.
Abstract:
Coarctation of the aorta (COA) is one of the more common congenital anomalies, occurring in four in ten thousand live births and accounting for five to eight percent of all congenital heart defects. COA lesions can be challenging to treat percutaneously, especially if complex vascular anatomy is a barrier to crossing the lesion. We present two cases of COA that utilized a trans-septal approach to cross the lesion in anterograde fashion, subsequently facilitating retrograde stenting of the lesions after snaring and externalizing the wire. In both cases, the trans-septal approach was employed because traditional femoral and radial approaches failed due to complex anatomy, and the trans-septal approach allowed for effective intervention without the need for surgery.
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