Abstract
BackgroundAortic coarctation (CoAo) accounts for 6 to 8% of all congenital heart diseases and occurs two to five times more often in males. The uncorrected aortic coarctation is complicated by hypertension, ascending and descending aortic aneurysms, endarteritis, and heart failure. The aortic pseudo-aneurysm (APD) usually occurs in patients with endarteritis. We report an adult man with bicuspid aortic valve, perimembranous ventricular septal defect, and uncorrected aortic coarctation complicated by descending aortic pseudo-aneurysm without aortic endarteritis.Case presentationA 40-year-old man was referred to our division for hemoptysis and severe aortic coarctation. Echocardiography confirmed the aortic coarctation diagnosis and showed a large aortic pseudo-aneurysm at the coarctation site with intra-cavity mural thrombus. Subsequently, the patient underwent contrast-enhanced computed tomography angiography, and diagnosis of coarctation and APD was confirmed. Due to various malformations and considering that the patient had become unstable due to hemoptysis, it was discussed in the heart team, and it was decided that the patient would undergo staged surgery.ConclusionsThe aortic pseudo-aneurysm is a rare complication in patients with untreated coarctation that requires prompt surgery, and this complication should be considered in patients with untreated aortic coarctation who present with hemoptysis.
Highlights
Aortic coarctation (CoAo) accounts for 6 to 8% of all congenital heart diseases and occurs two to five times more often in males
The aortic pseudo-aneurysm is a rare complication in patients with untreated coarctation that requires prompt surgery, and this complication should be considered in patients with untreated aortic coarctation who present with hemoptysis
We report an adult man with bicuspid aortic valve (BAV), perimembranous ventricular septal defect (VSD), and uncorrected aortic coarctation complicated by descending aortic pseudo-aneurysm without aortic endarteritis
Summary
Aortic coarctation (CoAo) accounts for 6–8% of all congenital heart diseases and affects 4/10,000 live births with male dominance. Two-dimensional transthoracic echocardiography (2D-TTE) was performed and showed a restrictive perimembranous ventricular septal defect (VSD) with peak gradient 119 mmHg, bicuspid aortic valve with severe insufficiency, and dilatation of the ascending aorta (approximately 46 mm) associated with a typical aortic coarctation at typical site (Fig. 1). The second stage of surgery, which is related to the correction of aortic insufficiency and VSD, has not been performed yet
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