Three-Dimensional Imaging of Aortic Aneurysm After Balloon Angioplasty for Coarctation of the Aorta
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.
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.
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 Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
- Copyright © 1999 by American Heart Association