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Spontaneous Bleeding From Multiple Intercostal Arteries in a Patient With Coarctation of the Aorta

Sean C Wightman1, Yoyo Wang1, Aaron M Rohr2

  • 1Department of Cardiothoracic Surgery, Stanford University Hospitals and Clinics, Stanford, California.

The Annals of Thoracic Surgery
|February 9, 2020
PubMed

A 59-year-old man with a history of coarctation repair, mechanical aortic valve, and warfarin therapy presented with right flank pain. Computed tomography showed a large hematoma encircling an intact descending thoracic aorta. Computed tomography angiography demonstrated multiple areas of intercostal artery extravasation. An interventional radiologist performed angiography and embolization. The patient's course was complicated by an effusion and hypoxia, but no further bleeding was noted. We hypothesize that coarctation associated aneurysms and potential vessel wall weakness are the causes of hematoma in our case. We present this case with history of repaired coarctation with multiple spontaneous intercostal artery aneurysmal rupture.

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