Middle Aortic Syndrome: Pathogenesis, Visceral Manifestations, and Management

Middle aortic syndrome (MAS) is characterized by severe narrowing of the abdominal aorta, frequently involving the great abdominal vessels. Although increasingly implicated in primary hypertension, up to one-third of cases affect the mesenteric vasculature, and the resultant manifestations may be underrecognized. Early intervention with interdisciplinary medical management and invasive arterial reconstruction affords preservation of end-organ function and improvement in patient survival. This article reviews the embryology of the thoracoabdominal aorta and major abdominal arteries, as well as the pathogenesis, clinical manifestations, and management of the nonatherosclerotic abdominal coarctation otherwise known as MAS.

Transcatheter Therapy for Coarctation of Aorta: Analysis of 150 Cases

Background: This study was conducted to analyze the outcome of transcatheter intervention of Coarctation of aorta carried out on 150 patients.Methods: This was a retrospective study, conducted in Pediatric Cardiology Unit, Combined Military Hospital Dhaka and Lab Aid Cardiac hospital from January 2007 to December 2015. Data were collected by chart review.Results: Age of the patient varies from 7 days to 28 years. Sixty six (44%) patients were female and rest were male. Native coarctation was 138 (92%) and post surgical re-coarctation was 12 (8%). Neonatal critical Coarctation was 60 (40%). Thirty six (24%) cases were detected when they were investigated for hypertension. Abdominal coarctation was found in 18 cases (12%). Multiple coarctation was found in 9 (6%) cases. Six cases (4%) had balloon angioplasty twice and 12(8%) cases had stenting after recoarctation as they had body weight above 15 kg. Aneurysm and aortic dissection was observed in one (0.66%) case. Thrombophlebitis observed in 3(2%) cases and temporary pulse loss in 9 (6%) cases. No mortality was noticed.Conclusion: Balloon angioplasty for coarctation of aorta and stenting in suitable cases is a safe and effective measure to treat coarctation of aorta.Cardiovasc. j. 2017; 10(1): 56-62

A rare cause of cardiomyopathy in an infant: middle aortic syndrome

Coarctation of the abdominal aorta is a rare condition with a handful of cases reported in infancy. We report the case of a 4-month-old infant with severe abdominal coarctation who presented with dilated cardiomyopathy. Following successful transcatheter-based stenting of her abdominal aorta, her cardiomyopathy resolved.