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(Circulation. 1999;100:1673-1674.)
© 1999 American Heart Association, Inc.

Images in Cardiovascular Medicine

Three-Dimensional Imaging of Aortic Aneurysm After Balloon Angioplasty for Coarctation of the Aorta

Kenji Hamaoka, MD, PhD; Hisashi Satou, MD; Koichi Sakata, MD, PhD; Zenshiro Onouchi, MD, PhD

From the Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Correspondence to Dr Kenji Hamaoka, Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyou-ku, Kyoto 602-8566, Japan. E-mail khamaoka@koto.kpu-m.ac.jp

	Introduction

 
A15-year-old girl was referred to our hospital for reevaluation and balloon angioplasty of a previously documented coarctation of the aorta. She had undergone coarctectomy at age 1 week and patch closure of a ventricular septal defect at age 1 year. Three years before referral, she had received balloon angioplasty to relieve postoperative restenosis of the descending aorta; this improved the pressure gradient from 36 to 18 mm Hg. A 2-dimensional echocardiogram showed stenosis of the descending aorta with a pressure gradient of 40 mm Hg. Helical CT clearly demonstrated not only a stenotic lesion of the descending aorta but also an aneurysm 8 mm in length and 5 mm in diameter, with a thin inner area and a thicker outer area just distal to the stenotic lesion (Figure 1). Conventional aortography and cine-mode MRI also revealed a mushrooming aneurysm without pulsation on the lateral view (Figure 2), but not as clearly as with helical CT. The patient underwent resection of the aortic aneurysm and grafting with a Hemashield graft. The postoperative course was uneventful.

View larger version (72K): [in this window] [in a new window]   Figure 1.

View larger version (84K): [in this window] [in a new window]   Figure 2.

Aortic aneurysm after balloon angioplasty for coarctation of the aorta is a rare but serious complication. Because helical CT could construct images from the optional angle, it was a useful, noninvasive alternative for early evaluation of the 3-dimensional structure and its relationship to the neighboring tissues.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart . . . [Full Text of this Article]

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