Coarctation of the aorta with aortic and subclavian artery aneurysms

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Diseases

Background:

• Coarctation of the aorta (CoA) is a congenital narrowing of the aorta, typically diagnosed in childhood.
• Adult-onset CoA is uncommon, presenting unique diagnostic and management challenges.
• Aneurysm formation in CoA, particularly in adulthood, is a rare complication.

Observation:

• A rare case of adult-onset coarctation of the aorta is presented.
• The patient exhibited complex comorbidities including coronary artery disease and bilateral bullae.
• Multiple aneurysms were observed: left subclavian artery aneurysm, saccular aortic aneurysms proximal to the coarctation, and aneurysms originating from the coarctation segment itself.
• A remnant of the ductus arteriosus was also noted.

Findings:

• Surgical management of adult coarctation is complicated by calcifications and associated comorbidities.
• The case demonstrates a rare confluence of aortic coarctation, extensive aneurysm formation, and other significant cardiovascular and pulmonary pathology.
• Histopathologic evaluation is crucial for understanding the mechanisms of aneurysm formation in this context.

Implications:

• This case underscores the importance of considering rare presentations of coarctation of the aorta in adults.
• Complex surgical strategies are required for managing coarctation with extensive aneurysmal disease.
• Further research into the histopathology of aneurysm formation in coarctation may inform future treatment approaches.