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Published on: July 7, 2013
Postcoarctoplasty Stent Infective Aortitis
Yasmin Mohtasham Kia1, Saeid Hosseini2, Mehdi Maghsudi3
1Vascular Disease and Thrombosis Research Center, Rajaie Cardiovascular Institute, Tehran, Iran; Cardiovascular Imaging Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Insights
Infective aortitis following coarctoplasty is rare but serious. Early detection of concomitant defects like patent ductus arteriosus (PDA) and prompt treatment are crucial for recovery.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Medical Imaging
Background:
- Infective aortitis is a rare but severe complication after coarctoplasty.
- Undiagnosed congenital heart defects, such as patent ductus arteriosus (PDA), can worsen outcomes.
Background:
Infective aortitis is a rare complication following coarctoplasty. Unrecognized concomitant congenital defects such as patent ductus arteriosus (PDA) could be devastating.
Case Summary:
We describe a young woman presenting with constitutional symptoms, elevated inflammatory markers, and a history of coarctoplasty with stent a decade earlier. Imaging revealed a large previously overlooked PDA and an aortic pseudoaneurysm distal to the stent covered by vegetations. Positron emission tomography/computed tomography demonstrated metabolically active lesions within the pulmonary artery and spleen. Broad-spectrum antibiotics, surgical stent excision, pseudoaneurysm repair with homograft, and PDA ligation achieved favorable outcomes with no residual infection on follow-up.
Discussion:
Sophisticated diagnostic modalities and a multidisciplinary approach are essential in rare, life-threatening complications. With growing use of endovascular therapies for aortic coarctation, awareness of uncommon complications and their management is crucial.
Take-Home Messages:
A comprehensive preprocedural assessment to detect coexisting anomalies is essential. Multimodality imaging is key for diagnosis, treatment planning, and follow-up. Combined antibiotic therapy and surgical intervention ensured complete recovery.
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