ABSTRACT
The coarctation of the aorta [CoA] is rare in adulthood. Diagnosis is made by clinical suspicion and physical findings such as blood pressure difference between the upper and lower extremities, pulse delay in the femoral artery, and systolic murmur over the thoracic spine. The CoA in adulthood and in patients with associated aneurysm is challenging and different complications even with proper treatment can occur. Covered stents are indicated in concomitant aneurysm, older age, and tight coarctation. A 26-year-old male with resistant hypertension due to a CoA diagnosed by computed tomography angiography referred to our center for an attempted stent implantation. Cardiac catheterization and aortography revealed a long CoA after the origin of the left subclavian artery with a 60 mmHg gradient. Moreover, there was a large aneurysm in the site of the coarctation. Under general anesthesia and fluoroscopic guidance, two balloon-expandable covered Cheatham-Platinum stents [size 18 in 44 millimeters and size 18 in 50 millimeters] were successfully implanted across the CoA with no residual gradient. On 2 years' follow-up, the patient had no symptoms except for mild hypertension. In this patient, the use of a covered stent within the aneurysm was safe and effective
ABSTRACT
Intracranial arteriovenous malformation rarely causes pulmonary hypertension and congestive heart failure in the newborn. Its diagnosis is challenging because cardiomegaly may suggest an intra-cardiac structural lesion. We present two newborns, one 2-day-old male and the other 11-day-old female, with intracranial arteriovenous malformation and misdiagnosis of congenital heart disease. Precise echocardiography revealed the secondary signs of cranial arteriovenous malformation and had the major role in early diagnosis