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Saccular “Cauliflower” aneurysm of coarctation of aorta: a hybrid management

Published online by Cambridge University Press:  03 August 2020

Neha Bansal Open the ORCID record for Neha Bansal [Opens in a new window] ,
Thomas J. Forbes  and
Sanjeev Aggarwal
Neha Bansal*
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital at Montefiore, Bronx, NY, USA
Thomas J. Forbes
Affiliation:
Division of Cardiology, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
Sanjeev Aggarwal
Affiliation:
Division of Cardiology, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
*
Author for correspondence: Neha Bansal, MD, Division of Pediatric Cardiology, Children’s Hospital at Montefiore, 3415 Bainbridge Ave- R1, Bronx, NY10467, USA. Tel.: +1 718-741-2313; Fax: +1 (718) 920 4351. E-mail: nbansal@montefiore.org
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Abstract

Aneurysm formation around the site of coarctation of aortic arch is a well-recognised complication of untreated coarctation and is associated with an increased risk of aortic rupture and mortality. We present a rare case in a teenage girl with the combination of significant aortic arch coarctation, a “cauliflower-like” saccular aneurysm, and stenosis at the origin of the left subclavian artery. She was successfully managed with a hybrid approach, which is a combination of an endovascular surgical repair (a bypass graft placement from left carotid artery to subclavian artery by a vascular surgeon) and a transcatheter covered stent placement across the stenosis and aneurysm. This case highlights the successful role of a hybrid approach in patient’s who present with a combination of coarctation of the aorta and aortic arch aneurysms. This approach avoids the conventional surgical aortoplasty, which carries a higher mortality and morbidity risk in teenage patients.

Keywords

Coarctation of aortasaccular aneurysmhybrid
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1360 - 1362
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Pu, XB, Chen, SJ, Chen, M, Feng, Y.Two-stage hybrid treatment strategy for an adult patient with aortic arch coarctation, poststenotic aneurysm, and hypoplastic left subclavian artery: a case report. Medicine 2017; 96: e8618.CrossRefGoogle ScholarPubMed
Hormann, M, Pavlidis, D, Brunkwall, J, Gawenda, M.Long-term results of endovascular aortic repair for thoracic pseudoaneurysms after previous surgical coarctation repair. Interact Cardiovasc Thorac Surg 2011; 13: 401–404.CrossRefGoogle ScholarPubMed
Di Tommaso, L, Mannacio, VA, Di Tommaso, E, Pinna, GB, Fontana, I and Iannelli, G.Endovascular treatment of distal aortic arch aneurysm associated with coarctation of aorta in a Jehovah’s witness. Texas Heart Inst J 2017; 44: 399–401.CrossRefGoogle Scholar
Bai, J, Liu, Y, Jin, J, Li, J, Ji, X, Qu, L.Single-stage endovascular management of complicated thoracic aorta coarctation concurrent with aortic arch aneurysm using a novel fenestration device. J Thorac Dis 2018; 10: 2474–2480.CrossRefGoogle ScholarPubMed
Rothman, A, Ciccolo, ML, Galindo, A, Evans, WN.Left subclavian artery test balloon occlusion before covered stent for recoarctation and aneurysm. World J Pediatr Cong Heart Surg 2019: 2150135118817309.Google ScholarPubMed
Preventza, O, Livesay, JJ, Cooley, DA, Krajcer, Z, Cheong, BY, Coselli, JS.Coarctation-associated aneurysms: a localized disease or diffuse aortopathy. Ann Thorac Surg 2013; 95: 1961–1967; discussion 1967.CrossRefGoogle ScholarPubMed
Ozyuksel, A, Canturk, E, Dindar, A, Akcevin, A.Saccular aneurysm formation of the descending aorta associated with aortic coarctation in an infant. Rev Bras Cir Cardiovasc 2014; 29: 642–644.Google ScholarPubMed
Khavandi, A, Bentham, J, Marlais, M, et al.Transcatheter and endovascular stent graft management of coarctation-related pseudoaneurysms. Heart (Br Cardiac Soc) 2013; 99: 1275–1281.Google ScholarPubMed
Bell, RE, Taylor, PR, Aukett, M, Young, CP, Anderson, DR, Reidy, JF.Endoluminal repair of aneurysms associated with coarctation. Ann Thorac Surg 2003; 75: 530–533.CrossRefGoogle ScholarPubMed