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PubMedDate not supplied

Surgical management of coarctation of aorta.

Between 1961 and 1988, 68 patients underwent operation for coarctation of the aorta. The average age of presentation of these subjects was higher than in other series. 7.1 percent were asymptomatic, a finding which is not seen in reports from the west. Operative procedures included resection and end to end anastomosis, resection and graft interposition, bypass grafting, patch aortoplasty and subclavian flap aortoplasty. However, the technique of patch aortoplasty, routinely performed in the last 24 years of this series seemed by far the most satisfactory procedure. Subclavian flap aortoplasty was carried out in a selected group of younger children. Associated cardiac anomalies influenced the results adversely. The overall operative mortality was 5.8 percent. Hypertension did not regress in 11.7 per cent of patients inspite of a successful operation as judged by the return of peripheral pulses in the lower limbs. Re-coarctation was not seen in this series. The overall results of operation for coarctation of the aorta have been very satisfactory and comparable with those in other published series.

Adolescent↗
PubMed1983

Expiration induced femoral flow in neonatal coarctation of aorta.

In a 3 day old infant with coarctation of the aorta a loud Doppler signal synchronous with expiration was present for some hours in the femoral vessels, with only barely audible signals synchronous with cardiac systole. It is suggested that in the presence of severe aortic constriction and temporary ductal closure, blood was pumped through the infradiaphragmatic arteries by increased intrathoracic expiratory pressure.

Aortic Coarctation↗
PubMedDate not supplied

Follow-up results of balloon angioplasty for native coarctation of aorta.

Balloon angioplasty of native discrete (< 1 cm) coarctation of thoracic aorta was performed in 29 patients [aged 13 to 31 years (mean 21.5 +/- 5.8 years), 22 males and 7 females], from March 1993 to December 1995. The patients were followed up for two years. After angioplasty, peak systolic arterial pressure (PSAP) decreased from 173.5 +/- 18.1 mm Hg to 122.5 +/- 9.9 mm Hg (p < 0.001), peak systolic pressure gradient (PSG) decreased by 90.9 percent from 86.2 +/- 15.77 to 7.77 +/- 3.8 mm Hg (p < 0.001) and the coarcted segment diameter increased about three times from 3.7 +/- 1.6 to 10.9 +/- 3.3 mm (p < 0.001). PSG decreased to < 10 mm Hg in 27 patients (93%) whereas in the other two patients PSG was 17 and 13 mm Hg. Restenosis appeared in 2 patients (6.8%); aneurysm in one patient (3.4%) which remained static even after 1.3 years of follow-up; mild dissection in 3 patients (10.3%); temporary femoral artery occlusion in 2 (6.8%) patients who recovered with heparin injection. Though hypertension disappeared after balloon dilatation in all patients, it reappeared in 3 patients (10.3%) within 7 days and in 10 patients (34.5%) within 6 months. In conclusion, balloon angioplasty of CoA is a good alternative to surgical correction.

Adolescent↗
PubMed2000

Severe migraine associated with coarctation of aorta: complete recovery following balloon dilation.

We report on a rare association of severe migraine headaches associated with coarctation of aorta that completely resolved following dilation of the constricted aorta. A 6-year-old girl presented with severe pounding headaches accompanied with recurrent vomiting, associated with photophobia and phonophobia. She experienced frequent awakenings with severe headaches and vomiting. The described excruciating, prolonged, and practically persistent headaches were not relieved by analgesics and ergotamines. Neurologic assessment and brain computed tomography were both normal. A systolic murmur at the third right intercostal space prompted a cardiac echocardiogram, which demonstrated coarctation of the ascending aorta beyond the orifice of the left common carotid artery. Catheterization revealed a systolic gradient of 54 mm Hg, and the constricted lumen of the aorta was then dilated by a balloon. The excruciating vascular headaches and associated symptoms had abated instantaneously following this procedure. To the best of our knowledge, this is the first report associating severe migraine headaches in a child with coarctation of the aorta. Given complete recovery following balloon dilation of the aorta, cardiac echocardiogram should be added to the diagnostic battery of children with severe unresponsive migraine.

Aortic Coarctation↗
PubMed1995

The presence of both horseshoe and a supernumerary kidney associated with coarctation of aorta.

Congenital urinary malformations associated with congenital heart disease are very rare. We present a case of horseshoe and supernumerary kidney associated with coarctation of aorta diagnosed by a combination of techniques of teleradiography, aortography, intravenous pyelography; ultrasonography, magnetic resonance imaging, and Dimercapto Succinic Acid (DMSA) and Diethylene Triamine Pentacetate (DTPA) imaging. This case represents the first reported instance of horseshoe and supernumerary kidney associated with coarctation of aorta.

Abnormalities, Multiple↗
PubMed1979

Dissection of an aneurysmal ascending aorta in association with coarctation of the aorta.

A previously fit 21-year-old man presented with severel central chest pain. Clinical, electrocardiographic, and echocardiographic examination confirmed a dissection of an aneurysmal ascending aorta in the presence of previously undiagnosed severe aortic coarctation. Initial aortic dissection had occurred five days before admission. The medical and staged surgical management of the case are presented. Surgical survival with such a combination of lesions does not appear to have been previously recorded.

Adult↗