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Cost of a delay.

Aditya Pradhan1, Yajvender Pratap Singh Rana1, Harish K Sinha1

  • 1Department of Urology and Renal Transplant, BLK Superspeciality Hospital, New Delhi, India.

BMJ Case Reports
|April 22, 2019
PubMed
Summary
This summary is machine-generated.

A rare case of undiagnosed coarctation of the aorta (CoA) in a renal transplant recipient was discovered during surgery. Prompt diagnosis and intervention allowed for a successful transplant a week later.

Keywords:
hypertensionrenal systemtransplantation

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Area of Science:

  • Nephrology
  • Cardiovascular Surgery
  • Medical Diagnostics

Background:

  • Live-related renal transplantation is a common procedure.
  • Undiagnosed congenital heart defects can complicate surgical outcomes.
  • Coarctation of the aorta (CoA) is a congenital narrowing of the aorta.

Observation:

  • A renal transplant surgery was abandoned due to the intraoperative discovery of previously undiagnosed coarctation of the aorta (CoA).
  • Diagnosis was confirmed by absent femoral pulses, Doppler findings of monophasic iliac artery flow, and a significant radial-iliac arterial pressure gradient (50 mmHg).

Findings:

  • Surgical intervention for coarctation of the aorta (CoA) involved CT aortogram, angioplasty, and bare metal stent placement.
  • The renal transplant was successfully performed one week after the CoA correction, with an uneventful patient recovery.

Implications:

  • This case underscores the critical importance of thorough preoperative cardiovascular assessment, including evaluation of peripheral pulses and detection of radiofemoral delay.
  • Enhanced preoperative screening protocols may be necessary to identify subclinical coarctation of the aorta in potential renal transplant recipients.
  • Timely diagnosis and management of coarctation of the aorta can enable successful renal transplantation in affected individuals.