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Endovascular Repair of a Pseudoaneurysm After Multiple Open Repairs of Aortic Coarctation
Saleh A Alnasser1, Kalyan C Vunnamadala1, Ourania A Preventza1
1Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine; and Department of Cardiovascular Surgery, Texas Heart Institute; Houston, Texas 77030.
Insights
Endovascular repair offers a safe alternative for treating aortic pseudoaneurysms, a complication of childhood aortic coarctation repair. This minimally invasive approach shows promise for patients with complex surgical histories.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Surgical repair of aortic coarctation in childhood can lead to late complications, including pseudoaneurysm formation.
- Untreated pseudoaneurysms pose significant risks of morbidity and mortality; surgical treatment is associated with complications.
- Endovascular aortic repair is a safe alternative to open surgery, with favorable outcomes and fewer complications, particularly in patients with prior aortic surgeries.
Abstract:
Successful surgical repair of aortic coarctation during childhood may have major late complications such as pseudoaneurysm formation. If left untreated, pseudoaneuryms put patients at risk for morbidity and death; if treated surgically, they are associated with complications. Endovascular aortic repair, an established safe alternative to open surgical repair, is associated with encouraging outcomes and fewer complications, and it is especially feasible for patients who have undergone multiple aortic surgeries. We report the case of a 41-year-old man who underwent endovascular repair of a pseudoaneurysm after previous surgical corrections of an aortic coarctation at 6 and 14 years of age. The pseudoaneurysm, involving the distal portion of an ascending-to-descending aortic 20-mm Dacron bypass graft, was successfully excluded with a thoracic stent-graft and sealed off with vascular plugs to prevent both blood flow into the pseudoaneurysm and type II endoleak.
