Multislice Computed Tomography for the Evaluation and Follow-Up of Stenting of Aortic Coarctation
A 58-year-old woman with congenital recurrent aortic coarctation and severe aortic valve stenosis underwent ECG-gated 16-row multislice computed tomography (MSCT) angiography (Sensation 16, Siemens) of the thorax for treatment planning (Figure, A and B; Movie I). The MSCT scan revealed 2 consecutive stenoses: the first immediately distal to the origin of the left subclavian artery (<50% diameter reduction), and the second at the level of the isthmus (>50% diameter reduction).
On the basis of the risk of major surgery in this woman with severe aortic valve stenosis, we decided to stent (CP Stent; NuMed) the isthmic stenosis (Figure, C and D). During the procedure, the first stenosis was confirmed as hemodynamically less severe compared with the second one (16 mm Hg versus 50 mm Hg). After the procedure, the follow-up scan showed the correct position of the stent and its patency (Figure, E and F; Movie II). Then the patient underwent successful operative repair of her aortic valve stenosis.
Movies I and II are available in the online-only Data Supplement at http://www.circulationaha.org.
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 the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.