Case Report
Volume 7 Issue 9 - 2020
Hybrid Management of Complex Coarctation-Associated Aortapathy in an Adult: A Case Report
Melisa Kandemir1, Cahit Saricaoğlu1, Evren Ozcinar1, Mehmet Çakici1, Bahadir İnan1, Sadik Bilgiç2 and Ahmet Ruchan Akar1*
1Department of Cardiovascular Surgery, Heart Center, Ankara University School of Medicine, Ankara, Turkey
2Department of Radiology, Ibni-Sina Hospital, Ankara University School of Medicine, Ankara, Turkey
*Corresponding Author: Ahmet Ruchan Akar, Department of Cardiovascular Surgery, Heart Center, Ankara University School of Medicine, Ankara, Turkey.
Received: July 30, 2020; Published: August 18, 2020




Abstract

We report a 31-year-old male with upper extremity hypertension, untreated coarctation of the aorta, bicuspid aortic valve, and ascending aortic aneurysm measuring 8.5 cm. On admission, transthoracic echocardiography revealed severe aortic regurgitation, 27 mm aortic annulus, 48 mm aortic root diameter at the Valsalva sinuses. The ascending aorta was 85 mm. The patient underwent a hybrid retrograde balloon dilatation at the primary coarctation site to decrease afterload initially combined with the repair for a proximal aortic aneurysm through Bentall’s procedure. Postoperative recovery was uneventful, and the patient was discharged on the 10th postoperative day without any complication. At a one-year follow-up, he remained asymptomatic and free from antihypertensive medication. Our case represents a rare condition in adults that aortic coarctation-associated aortopathy involves aortic coarctation and a giant ascending aortic aneurysm with grade III aortic valvular insufficiency. This case report highlights the importance of a staged hybrid approach combining endovascular repair of coarctation first with subsequent open surgery of the ascending aorta in complex coarctation cases to avoid complications related to lower body hypoperfusion and upper body hypertension following cardiopulmonary bypass.

Keywords: Aortic Coarctation; Ascending Aortic Aneurysm; Hybrid Repair

References

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Citation: Ahmet Ruchan Akar., et al. “Hybrid Management of Complex Coarctation-Associated Aortapathy in an Adult: A Case Report”. EC Cardiology 7.9 (2020): 58-63.

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