Improved hemodynamics following endovascular treatment for acquired aortic coarctation: A case report

A 38-year-old man underwent surgical repair of a type A aortic dissection. After aortic surgery, his left ventricular ejection fraction was progressively reduced from 65% to 15%, causing a refractory low cardiac output depending on the intravenous inotropes. There was a luminal stenosis of the descending aorta due to enlarged pseudolumen. The peak-to-peak pressure gradient at the stenosis was 25 mmHg, which was thought to contribute to the systolic dysfunction. He underwent thoracic endovascular aortic repair (TEVAR) with the use of a bare self-expanding stent. After TEVAR, the peak-to-peak pressure gradient was decreased to 9 mmHg, resulting in hemodynamic improvement. <Learning objective: A case of refractory heart failure with severe impairment of left ventricular contractility aggravated by excessive left ventricular afterload due to a luminal stenosis in the descending aorta after surgical repair for type A aortic dissection was presented. Endovascular treatment for dilation of the stenosis contributed to the improved hemodynamics.>.