Endovascular Treatment for Pseudoaneurysms After the Surgical Repair of Aortic Coarctation

Abstract

In this report, we describe the case of a 28-year-old male who presented to our hospital with shortness of breath and sudden, severe central chest pain that radiated across his chest and back. The patient had a history of coarctation of the aorta (CoA) repair using Dacron patch aortoplasty at the age of 10 years, and he had been lost to clinical follow-up. A chest X-ray (CXR) revealed the widening of the upper mediastinum. He underwent emergency CT angiography, which demonstrated extensive mediastinal hematoma and contrast leaking from a 4x12 cm complex pseudoaneurysm of the proximal thoracic descending aorta. After the heart-team meeting, the transcatheter approach was deemed more feasible and safer than a surgical approach. The patient was taken to cardiac catheterization laboratory and, under general anaesthesia, we successfully implanted a tapered (28 mm - 26 mm) x 150 mm Valiant Thoracic Stent Graft with the Captivia Delivery System (Medtronic Vascular, Santa Rosa, CA). In this case, we demonstrated the feasibility and safety of using a stent graft to treat late surgical complications after CoA repair, which are not uncommon.