Aortic coarctation in adults: the role of multimodality cardiac imaging. Series of case reports and review of literature

Carmen Beladan,Dan Deleanu,Pavel Platon,Sebastian Botezatu,Bogdan A. Popescu,Mihai Teodor Bica,Carmen Ginghina,Maria Magdalena Gurzun

doi:10.47803/rjc.2021.31.1.76

Abstract

Abstract Coarctation of the aorta (CoA) is a relatively frequent congenital defect. Its natural evolution is marked by serious complications including aortic dissection, heart failure, coronary artery disease, infective endocarditis, or cerebral haemorrhages. Correction of CoA before complications arise is associated with a favourable long-term outcome. Timely diagnosis of CoA is therefore of utmost importance in the prognosis of these patients. Non-invasive imaging techniques, ranging from chest radiography to echocardiography, Cardiac Computed Tomography (CCT), and Cardiac Magnetic Resonance (CMR) have evolved to the extent where they can not only suggest but also precisely characterize the lesion and guide further management. We present a series of 3 case reports, highlighting the diagnostic approach and treatment for this pathology.

Highlights

Coarctation of the aorta (CoA) is a relatively frequent congenital defect and represents 5-8% of congenital cardiac defects[1]
Its natural evolution is marked by serious complications including aortic dissection, heart failure, coronary artery disease, infective endocarditis, or cerebral haemorrhages
We present a series of 3 case reports, highlighting the diagnostic approach and treatment for this pathology

Summary

INTRODUCTION

Coarctation of the aorta (CoA) is a relatively frequent congenital defect and represents 5-8% of congenital cardiac defects[1]. Considering the severity of CoA in a patient with refractory hypertension, the patient underwent balloon angioplasty, and a covered stent was placed with no residual pressure gradient or significant stenosis (Figure 1E, Figure 1F) The first echocardiographic evaluation after correction revealed a marked reduction in the peak systolic gradient at the level of the dilated area (16 mmHg). Subsequent clinical monitoring revealed normal blood pressure values at 1 month and uncomplicated evolution at 5 years post-procedure This case highlights the immediate and long-term benefits of catheter-based treatment in a hypertensive young patient with CoA, following surgical closure of a patent ductus arteriosus in childhood. The patient was clinically well, with good blood pressure control and improved exercise tolerance This case highlights the successful interventional treatment of aortic re-coarctation in an adult female patient, following surgical treatment in childhood. The case highlights the successful catheter-based treatment of post-ductal CoA in an adult patient with a late diagnosis

Findings

DISCUSSION

CONCLUSIONS