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Coarctation of the abdominal aorta
Insights
Coarctation of the abdominal aorta can cause severe hypertension and claudication. Surgical repair with Dacron bypasses effectively resolved symptoms in three patients, offering a viable treatment for this rare condition.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Interventional Radiology
Background:
- Coarctation of the abdominal aorta is a rare condition.
- It can lead to severe hypertension and mesenteric ischemia.
- Associated renal and mesenteric artery stenoses present complex challenges.
Observation:
- Four patients with coarctation of the abdominal aorta and renal/mesenteric artery involvement were identified.
- Three patients presented with severe hypertension, and two with intermittent claudication.
- One patient, diagnosed in 1974, was deemed inoperable and remained symptomatic.
Findings:
- Three patients underwent surgical intervention using Dacron grafts.
- Bypass procedures included thoracic to abdominal aorta grafts, with some extending to renal, celiac, and mesenteric arteries.
- The patient receiving a thoracic to femoral artery prosthesis also showed positive outcomes.
- Post-operatively, three surgically treated patients became asymptomatic and normotensive.
Implications:
- Surgical reconstruction with Dacron prostheses is a successful treatment for coarctation of the abdominal aorta with visceral artery involvement.
- Early diagnosis and surgical intervention can significantly improve patient outcomes, resolving hypertension and claudication.
- This approach offers a life-altering solution for patients with complex aortic and visceral artery disease.
Abstract:
Coarctation of the abdominal aorta with stenoses or occlusions of the renal and mesenterial arteries was diagnosed in four patients. Three of the patients had severe hypertension and two had intermittent claudication. All the patients had normal arteries in the legs. The first patient was diagnosed i 1974 and was judged at that time to be inoperable. He is still alive, but suffers from severe hypertension and intermittent claudication. The other three patients were diagnosed later and have all been surgically treated, two with Dacron bypasses from the thoracic to the abdominal aorta, one of them with supplemental Dacron bypasses to both renal arteries, the celiac axis, and the superior mesenteric artery. The last patient had a Dacron prosthesis from the thoracic aorta to both common femoral arteries implanted. Post-operatively, the three patients operated on were free from symptoms and normotensive.