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Coarctation of the aorta of unusual morphology
Insights
Unusual coarctation of the aorta cases, including double lesions and carotid location, were successfully treated with Dacron grafts. Long-term follow-up shows patients living normal lives after surgical reconstruction.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Medical Case Reports
Background:
- Coarctation of the aorta is a congenital narrowing of the aortic arch.
- Typical coarctation occurs at the aortic isthmus, near the ductus arteriosus.
- Atypical presentations require careful diagnosis and tailored surgical approaches.
Observation:
- Presents three rare coarctation of the aorta variants: double aortic constrictions, a carotid-located lesion with subclavian steal syndrome, and supradiaphragmatic coarctation.
- All cases involved successful surgical reconstruction using Dacron grafts.
- Long-term follow-up (8-12 years) demonstrated positive outcomes.
Findings:
- Unusual coarctation locations and configurations can be effectively managed with surgical intervention.
- Physical findings like limb hypertension and weak femoral pulses suggest potential coarctation.
- Aortography is crucial for precise diagnosis and surgical planning.
Implications:
- Highlights the importance of considering rare anatomical variations in coarctation of the aorta.
- Demonstrates the long-term efficacy of Dacron grafts in complex aortic reconstructions.
- Emphasizes the need for thorough diagnostic workup, including aortography, for optimal patient outcomes.
Abstract:
Three unusual types of coarctation of the aorta are presented together with long-term follow up covering a period of 8-12 years, after successful operative reconstruction. In one case there were two constrictive lesions, one proximal to the left subclavian artery and the other at the typical location, while in another the coarctation was located between two common carotids, with associated congenital hypoplasia of the left subclavian artery, resulting in a steal syndrome. In the last case, there was evidence of a supradiaphragmatic coarctation. In all cases surgical reconstruction was accomplished by means of a Dacron graft. Even unusually located coarctations are highly likely where physical examination reveals, either in one or both limbs hypertension with concomitant weakness of femoral pulsations. However aortography is mandatory for adequate delineation of the disease and precise surgical orientation. All three patients live a normal life today.