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Giant descending aortic pseudo-aneurysm in an adult man with uncorrected aortic coarctation

Zahra Jabbary1, Mehrnoush Toufan2

  • 1Cardiovascular Research Center, Shahid Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran. Dr.z.Jabbary@gmail.com.

The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology
|September 16, 2021
PubMed

Insights

Aortic pseudo-aneurysm is a rare complication of untreated aortic coarctation. This case highlights the importance of considering aortic pseudo-aneurysm in patients with aortic coarctation presenting with hemoptysis.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Aortic coarctation (CoAo) affects 6-8% of congenital heart disease cases, predominantly in males.
  • Untreated CoAo can lead to hypertension, aortic aneurysms, endarteritis, and heart failure.
  • Aortic pseudo-aneurysm (APD) is a rare complication, typically associated with endarteritis.

Purpose of the Study:

  • To report a case of descending aortic pseudo-aneurysm in an adult with uncorrected aortic coarctation.
  • To emphasize the diagnostic considerations for aortic pseudo-aneurysm in the context of aortic coarctation.
  • To discuss the management of this rare complication.

Main Methods:

  • Case presentation of a 40-year-old man with hemoptysis and severe aortic coarctation.
  • Diagnostic workup included echocardiography and contrast-enhanced computed tomography angiography.
  • Multidisciplinary heart team discussion for surgical planning.

Main Results:

  • Echocardiography revealed aortic coarctation and a large aortic pseudo-aneurysm with mural thrombus.
  • CT angiography confirmed the diagnosis of coarctation and aortic pseudo-aneurysm.
  • The patient presented with hemoptysis, indicating clinical instability.

Conclusions:

  • Aortic pseudo-aneurysm is a rare but serious complication of untreated aortic coarctation.
  • Prompt surgical intervention is necessary for aortic pseudo-aneurysm.
  • Hemoptysis in patients with untreated aortic coarctation warrants consideration of aortic pseudo-aneurysm.
Abstract

Keywords:
Aortic coarctationAortic pseudo-aneurysmEchocardiography

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