IMAGE IN CARDIOLOGY

DOI: 10.4244/EIJ-D-16-00570

Percutaneous repair of severe coarctation of the aorta

Sinjini Biswas1, MBBS; Leeanne Grigg1, MBBS; Lucas Eastaugh2, MBBS; Ronen Gurvitch1, MBBS; William Wilson1*, MBBS

A 21-year-old asymptomatic male was referred with severe hypertension. Blood pressure was 190/100 mmHg in both arms. Examination revealed absent femoral and pedal pulses. Electrocardiography showed sinus rhythm with left ventricular hypertrophy. Echocardiography demonstrated moderate left ventricular hypertrophy with a trileaflet aortic valve. Computed tomographic aortography (CTA) demonstrated severe discrete coarctation with a diameter of <1 mm at the aortic isthmus (Panel A), and invasive aortography (via dual injections) demonstrated complete aortic occlusion (Panel B).

Transcatheter intervention was performed via both radial and femoral arterial access (Moving image 1). The occlusion was crossed from above with an exchange length 0.035-inch straight wire (Terumo Corp., Tokyo, Japan), which was snared in the descending aorta (EN Snare®, 12-20 mm; Merit Medical, Galway, Ireland) and externalised to allow delivery of a 14 Fr Mullins sheath (Medtronic, Dublin, Ireland). An 8-zig 45 mm covered Cheatham-Platinum stent (NuMED, Hopkinton, NY, USA) was deployed on a 16 mm balloon without predilation. The invasive peak-peak gradient dropped from 60 to 0 mmHg. At one year, the patient remains well and is normotensive on one antihypertensive agent. Repeat CTA confirmed no aortic wall injury (Panel C).

Conflict of interest statement

The authors have no conflicts of interest to declare.

Supplementary data

Moving image 1. Video demonstrating percutaneous intervention on the coarctation of the aorta.

Supplementary data

To read the full content of this article, please download the PDF.

Video demonstrating percutaneous intervention on the coarctation of the aorta.

Volume 12 Number 12
Dec 20, 2016
Volume 12 Number 12
View full issue


Key metrics

Suggested by Cory

EXPERT REVIEW

10.4244/EIJV11I6A133 Oct 20, 2015
The effectiveness of stenting of coarctation of the aorta: a systematic review
Hartman E et al
free

Clinical research

10.4244/EIJ-D-18-00923 Mar 20, 2020
Percutaneous reintervention on aortic coarctation stenting
Pan M et al
free

INTERVENTIONAL FLASHLIGHT

10.4244/EIJ-D-16-00851 Jul 20, 2017
Stenting complex aortic coarctation: simulation in a 3D printed model
Pluchinotta F et al
free

Clinical research

10.4244/EIJ-D-18-00857 Feb 5, 2021
Long-term follow-up after recanalisation of aortic arch atresia
Chessa M et al
free

Clinical research

10.4244/EIJ-D-19-00157 Feb 5, 2021
Early and midterm outcomes of bare metal stenting in small children with recurrent aortic coarctation
van Kalsbeek R et al
free
Trending articles
151.43

State-of-the-Art

10.4244/EIJ-D-22-00776 Apr 3, 2023
Computed tomographic angiography in coronary artery disease
Serruys PW et al
free
55.9

Clinical research

10.4244/EIJ-D-22-00621 Feb 20, 2023
Long-term changes in coronary physiology after aortic valve replacement
Sabbah M et al
free
54.9

Expert review

10.4244/EIJ-D-21-01010 Jun 24, 2022
Device-related thrombus following left atrial appendage occlusion
Simard T et al
free
43.75

Clinical Research

10.4244/EIJ-D-21-01091 Aug 5, 2022
Lifetime management of patients with symptomatic severe aortic stenosis: a computed tomography simulation study
Medranda G et al
free
39.95

Clinical research

10.4244/EIJ-D-22-00558 Feb 6, 2023
Permanent pacemaker implantation and left bundle branch block with self-expanding valves – a SCOPE 2 subanalysis
Pellegrini C et al
free
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2024 Europa Group - All rights reserved