scholarly journals Case Report: Trans-axillary Artery Access for Rescue Stent Implantation in an Infant With Retrograde Non-passable Aortic Coarctation

2021 ◽  
Vol 9 ◽  
Author(s):  
Julia Moosmann ◽  
Ariawan Purbojo ◽  
Susanne Eder ◽  
Sven Dittrich
Keyword(s):  
Stent Implantation ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Axillary Artery ◽  
Coarctation Of The Aorta ◽  
Bridge To Surgery ◽  
Retrograde Approach ◽  
Traditional Treatment ◽  
Femoral Access ◽  
The Right

Primary surgical repair remains the traditional treatment for patients with critical duct-dependent coarctation of the aorta (CoA). Initial surgical repair might not be possible or associated with higher risks if additional comorbidities arise in small infants and neonates. Balloon angioplasty (BA) has been described as a rescue strategy for these children. We describe the feasibility of a palliative BA and rescue stent implantation via an alternative antegrade right-axillary artery approach in an initially inoperable infant with pneumonia and respiratory failure and severe CoA, where the stenosis was not passable by traditional retrograde femoral access. This case adds new aspects to the therapy of critical CoA: Stent implantation provides a bridge to surgery in critically ill infants and does not preclude successful surgical repair. Further, if the classic retrograde approach is not possible, the right axillary artery access should be considered as an alternative to pass the stenosis.

scholarly journals Palliative stenting in a newborn with critical coarctation of the aorta

2019 ◽  
Vol 23 (1) ◽  
pp. 78
Author(s):  
I. A. Soynov ◽  
Yu. Yu. Kulyabin ◽  
A. V. Gorbatykh ◽  
A. V. Voytov ◽  
A. Yu. Omelchenko ◽  
...  
Keyword(s):  
Informed Consent ◽  
Iliac Artery ◽  
Conflict Of Interest ◽  
Stent Implantation ◽  
Surgical Repair ◽  
Good Condition ◽  
Coarctation Of The Aorta ◽  
Multiple Organ ◽  
Arterial Duct ◽  
The Right

<p>Newborns with critical coarctation of the aorta with a closed arterial duct often require surgical repair. Primary repair is associated with a high risk of unfavorable outcomes owing to severe systemic outflow obstruction and multiple organ failure. We present the case of a premature male newborn (weight = 1.9 kg) with critical coarctation of the aorta and multiple organ dysfunction syndrome with a closed arterial duct who successfully underwent isthmus stenting as a palliative step before surgical repair. The indication for primary stent implantation was decompensated metabolic acidosis. For stenting, the retroperitoneal approach was selected, and elective surgical cut-down of the right iliac artery was performed. Standard coronary stents (diameter = 4 mm; length = 13 mm) were delivered via a 4F sheath. The right iliac artery was repaired after sheath removal. The procedure was successful, and there were no procedural complications. Four days after stent implantation, the patient was stable, and he then underwent surgery. The coronary stent was extracted, the aortic isthmus was divided, and an extended anastomosis was created. The surgery was performed without complications. On the fourth day, the newborn was transferred from the intensive care unit to the ward, and on the fifteenth day, he was discharged from the hospital in good condition. Hence, palliative stenting is beneficial in newborns with critical aortic coarctation in the decompensated state because it stabilizes and prepares them for subsequent radical surgery, thereby reducing the risk of severe complications and mortality.</p><div><p><strong>Informed consent:</strong> The written informed consent has been obtained from the patient’s parents for this publication.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Acknowledgment:</strong> We express our gratitude to Melina G. Galstyan for technical support in article writing.</p><p>Received 3 October 2018. Accepted 11 December 2018.</p><p> </p></div>

scholarly journals A rare case of pseudoaneurysm at the site of untreated coarctation of the aorta in an adult patient

2020 ◽  
Author(s):  
Takuma Mikami ◽  
Takeshi Kamada ◽  
Hiroki Uchiyama ◽  
Yosuke Kuroda ◽  
Ryo Harada ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysm ◽  
Aortic Coarctation ◽  
Poor Prognosis ◽  
Rare Case ◽  
Surgical Repair ◽  
Coarctation Of The Aorta ◽  
Pathological Findings ◽  
Open Surgical Repair ◽  
Risk Of Rupture

Abstract Here we report a rare case of pseudoaneurysm at the site of aortic coarctation. Aortic coarctation and a saccular aortic aneurysm protruding from the site of this coarctation were detected in a 50-year-old woman. Owing to the shape of the aneurysm and high risk of rupture, an open surgical repair was performed. The pathological findings of the removed aneurysm revealed a pseudoaneurysm consisting of only a thin adventitial wall. Adult uncorrected aortic coarctation has a poor prognosis. One of its causes may be the formation of such a pseudoaneurysm.

Remote congenital cerebral arteriovenous fistulae associated with aortic coarctation

1992 ◽  
Vol 76 (1) ◽  
pp. 137-142 ◽  
Author(s):  
Francis H. Tomlinson ◽  
David G. Piepgras ◽  
Douglas A. Nichols ◽  
Daniel A. Rüfenacht ◽  
Sue C. Kaste
Keyword(s):  
Caesarean Section ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Vascular Lesions ◽  
Prenatal Ultrasonography ◽  
Arteriovenous Fistulae ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ A neonate presented with anatomically discrete cerebral arteriovenous fistulae located in the right sylvian fissure and the cerebellar vermis that were initially detected by prenatal ultrasonography. Following delivery of the baby by Caesarean section, both malformations were treated by surgical obliteration. These intracranial vascular lesions were associated with cardiac anomalies and a periductal coarctation of the aorta, which was treated with a left subclavian rotational arterial pedicle repair. Follow-up examination of the infant at age 13 months demonstrated an excellent clinical result with normalization of the circulation. The pathophysiology of this syndrome is discussed and the literature reviewed.

Cerebral ischaemia after repair of coarctation of the aorta

2014 ◽  
Vol 25 (4) ◽  
pp. 780-782
Author(s):  
Maria Gogou ◽  
Anastasia Keivanidou ◽  
Andreas Giannopoulos
Keyword(s):  
Cerebral Infarction ◽  
Frontal Lobe ◽  
Balloon Angioplasty ◽  
Cerebral Ischaemia ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Paediatric Department ◽  
History Of ◽  
Transient Cerebral Ischaemia ◽  
The Right

AbstractA 9-year-old boy, with a history of repair of severe coarctation of the aorta through balloon angioplasty 2 weeks ago, presented in the emergency paediatric department with symptoms consistent with transient cerebral ischaemia. MRI revealed an area of cerebral infarction in the right frontal lobe. Causes of cerebral ischaemia after aortic coarctation repair are briefly discussed.

Aortic rupture during stenting for recurrent aortic coarctation in an adult: live-saving, emergency, NuDEL all-in-one covered stent implantation

2017 ◽  
Vol 27 (6) ◽  
pp. 1225-1228 ◽  
Author(s):  
Andreas Eicken ◽  
Stanimir Georgiev ◽  
Peter Ewert
Keyword(s):  
Stent Implantation ◽  
Aortic Coarctation ◽  
Aortic Rupture ◽  
Coarctation Of The Aorta ◽  
Covered Stent ◽  
Bare Metal ◽  
Life Saving ◽  
Catheter System

AbstractWe report a case of successful, life-saving implantation of a covered Cheatham Platinum stent, an all-in-one NuDEL catheter system, in an adult with aortic rupture after bare-metal stenting for re-coarctation of the aorta.

Anomalous left coronary artery arising from the right pulmonary artery in association with coarctation of the aorta

2015 ◽  
Vol 26 (4) ◽  
pp. 802-804
Author(s):  
Xuecun Liang ◽  
Lin Wu
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Coarctation Of The Aorta ◽  
Anomalous Left Coronary Artery ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Pulmonary Artery Fistula ◽  
Anomalous Left Coronary

AbstractIn this study, we describe a very rare case of anomalous left coronary artery arising from the right pulmonary artery in association with coarctation of the aorta. A 3-month-old boy presented with refractory congestive heart failure since 20 days after birth. The initial echocardiography suggested the diagnosis of left coronary artery-to-right pulmonary artery fistula associated with coarctation; however, selective coronary angiography demonstrated the rare anomaly of the left coronary artery arising from the right pulmonary artery. Subsequently, he underwent successful transcatheter balloon angioplasty for aortic coarctation and surgical repair of left coronary artery re-implantation.

THE SYNDROME OF "MESENTERIC ARTERITIS" FOLLOWING SURGICAL REPAIR OF AORTIC COARCTATION

PEDIATRICS ◽  
1972 ◽  
Vol 49 (1) ◽  
pp. 40-45
Author(s):  
Edgar C. K. Ho ◽  
Arthur J. Moss
Keyword(s):  
Postoperative Period ◽  
Early Treatment ◽  
Aortic Coarctation ◽  
Direct Relationship ◽  
Surgical Repair ◽  
Antihypertensive Drugs ◽  
Coarctation Of The Aorta ◽  
Bowel Necrosis ◽  
Duration Of Symptoms

The mesenteric arteritis syndrome describes a group of complications which may follow surgical repair of coarctation of the aorta. The etiology is unknown but there appears to be a direct relationship to the hypertension which is observed in the postoperative period in these cases. Recognition of this complication and early treatment of the hypertension with antihypertensive drugs will shorten the duration of symptoms, and may prevent the development of bowel necrosis and possible death.

scholarly journals Comparison of surgical repair and percutaneous stent implantation for native coarctation of the aorta in patients ≥15years of age

2016 ◽  
Vol 203 ◽  
pp. 629-631 ◽  
Author(s):  
Xianglin Yeaw ◽  
Dale J. Murdoch ◽  
Vishvanatha Wijesekera ◽  
John F. Sedgwick ◽  
Christopher M. Whight ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Surgical Repair ◽  
Coarctation Of The Aorta

Behandlung akuter embolischer Verschlüsse der A. subclavia und A. axillaris mit einem Rotationsthrombektomie-Katheter

VASA ◽  
2003 ◽  
Vol 32 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Zeller ◽  
Frank ◽  
Bürgelin ◽  
Sinn ◽  
Horn ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Brachial Artery ◽  
Left Subclavian Artery ◽  
Axillary Artery ◽  
Duplex Ultrasound ◽  
Sudden Onset ◽  
Femoral Access ◽  
Thrombectomy Device ◽  
The Right ◽  
Pain At Rest

Acute embolic or local thrombotic ischaemia of the upper limbs can be treated by embolectomy or by endovascular techniques. We report here on the endovascular thrombectomy of acute embolic occlusions of subclavian and axillary arteries in two patients using a rotational thrombectomy device and give an overview about the actual literature. Two female patients, each with a history of multi-vessel coronary disease and intermittent atrial fibrillation, complained of sudden onset of pain at rest and paleness of the left and right arm, respectively. Duplex ultrasound showed a localized embolic occlusion of the left subclavian artery and the bifurcation of the brachial artery in the first patient and a localized embolic occlusion of the distal right subclavian and axillary artery in the second patient. In the first patient, the left subclavian artery was reopened using a 8F-Rotarex device via the femoral access, while the bifurcation of the brachial artery was reopened by local thrombolysis using 25 mg rt-PA because of the insufficient length of the thrombectomy device of 80 cm. In the second patient, the right subclavian and axillary arteries were reopened using a 6F-Rotarex device. Follow-up examinations before discharge and after 6 months showed normalized perfusion of the arms of both patients.

Cheatham platinum stent implantation in children with coarctation of the aorta: single-centre short-term, intermediate-term, and long-term results from Turkey

2013 ◽  
Vol 24 (4) ◽  
pp. 675-684 ◽  
Author(s):  
Ali Baykan ◽  
Nazmi Narin ◽  
Abdullah Ozyurt ◽  
Mustafa Argun ◽  
Ozge Pamukcu ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Aortic Coarctation ◽  
Antihypertensive Drugs ◽  
Coarctation Of The Aorta ◽  
Arterial Injury ◽  
Stent Migration ◽  
Long Term Results ◽  
Complication Rates ◽  
Significant Difference

AbstractObjectives: Our aim was to evaluate patients who were treated by percutaneous stent implantation. Methods: Patients with aortic coarctation (n = 35) who had been treated with 38 stents – 12 bare and 26 covered – were evaluated. The demographics and procedural and follow-up data were recorded from hospital registers and compared according to patient specifications, for example, weight and coarctation nature. Results: The procedure was successful in all patients. There was a statistically significant difference between the patients with native coarctation (n = 17) and those with recurrent coarctation (n = 18) in terms of pre-procedural blood pressures, systolic gradients, coarctation diameters, and the ratio of the coarctation site diameter to the descending aorta diameter. Although all patients received antihypertensive drugs before the procedure, the drug was discontinued in 26 patients during follow-up (p < 0.001). Stent migration was observed in four patients with recurrent coarctation (11.4%), and peripheral arterial injury was seen in three patients (8.5%). The mean follow-up time was 34 ± 16 months. On average, 21 (6–42) months after the procedure, six patients underwent cardiac catheterisation. At least 2 years after the procedure, tomography was performed in 20 patients (57.2%). Patients who were evaluated by multi-slice computerised tomography revealed no pathologies. There was no statistically significant difference between the five patients weighing less than 20 kg and the other 30 patients in terms of demographic and procedural characteristics, procedure success and complication rates, and follow-up data. Conclusion: Stent implantation for aortic coarctation is a method yielding satisfactory results in reducing coarctation gradients, efficient enlargement of the lesion area, and resolution of hypertension for children, including those weighing less than 20 kg.

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