Abdominal aorta coarctation: the first three case reports in our literature

• Published in: Srpski arhiv za celokupno lekarstvo Vol. 138; no. 7-8; pp. 489 - 493
• Main Authors: Gajin, Predrag, Tanasković, Slobodan, Nenezić, Dragoslav, Ilijevski, Nenad, Radak, Djordje
• Format: Journal Article
• Language: English; Serbian
• Published: Serbia Serbian Medical Society 01.07.2010
• Subjects: abdominal aorta coarctation; Aorta, Abdominal - abnormalities; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - surgery; Aortic Coarctation - diagnostic imaging; Aortic Coarctation - surgery; Child, Preschool; Female; Humans; Male; Middle Aged; Radiography; surgical treatment; transluminal percutaneus angioplasty
• ISSN: 0370-8179; 2406-0895
• DOI: 10.2298/SARH1008489G

Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0%) of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called "middle aortic syndrome" or "mid-aortic dysplastic syndrome". This represents serious pathological condition and indicates multidisciplinary therapy approach. From 1996 to 2007, at the Vascular Surgery Clinic of the Institute for Cardiovascular Diseases "Dedinje", Belgrade, three patients were treated due to abdominal aorta coarctation, two females aged 55 and 50 and a 4-year-old child. The patients were treated surgically (by-pass with a prosthetic graft and patch angioplasty) and endovascular- percutaneous transluminal angioplasty (PTA) with and without a stent. The follow-up period was 3-70 months. In the 50-year-old patient, angiography showed severe narrowing of the suprarenal segment of the abdominal aorta. Thoraco-abdominal bypass with a 16 mm dacronic tubular graft was performed. In the 4-year-old patient angiography also showed a suprarenal aorta narrowing. In the first act patch angioplasty was performed and after PTA of the visceral arteries was done on several occasions. In the 55-year-old patient, after diagnostic angiography, infrarenal aorta coarctation was registered. PTA was performed with stent placement. All patients were asymptomatic on control check-ups. Abdominal coarctation is a pathological disease which is seldom found in vascular surgery. Angiography is of major importance for setting the diagnosis and for the control of the results of surgical and nonsurgical treatment. The combination of surgical and endovascular treatment in our patients showed very good results in the studied period.