Thoracic Endografting for Aortic Occlusion after Coarctation Surgery

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Interventional Cardiology

Background:

• Acute descending thoracic aorta (DTA) occlusion is a rare but life-threatening condition.
• Previous open repairs for aortic coarctation can complicate management of subsequent aortic events.
• Lower body hypoperfusion signifies critical compromise in DTA occlusion.

Observation:

• A 59-year-old male presented with acute DTA occlusion.
• The patient had a history of two prior open repairs for aortic coarctation.
• The acute DTA occlusion led to significant lower body hypoperfusion.

Findings:

• Rescue thoracic endovascular aortic repair (TEVAR) was performed as an emergency procedure.
• The TEVAR procedure successfully re-established aortic flow and resolved hypoperfusion.
• The patient's outcome was favorable following the rescue intervention.

Implications:

• TEVAR can be a viable and effective treatment option for acute DTA occlusion, even in complex cases with prior surgeries.
• This case highlights the importance of considering endovascular options for managing acute aortic emergencies.
• Successful rescue TEVAR in this scenario may improve outcomes for patients with challenging aortic pathologies.