A Successful Case of Thoracic Endovascular Aortic Repair for the Treatment of Adult Aortic Coarctation

Abstract

We report a successful case of adult aortic coarctation treated with thoracic endovascular aortic repair. A 47-year-old man was admitted to our hospital with uncontrollable hypertension and systolic murmur in his back. A contrast-enhanced CT scan revealed that the stenotic lesion with the saccular aneurysm at the isthmus of the descending aorta, which is diagnosed as aortic coarctation. The ABI was 0.62 on the right and 0.63 on the left. We decided to perform thoracic endovascular aortic repair for the treatment of the coarctation. The procedure was carried out under general anesthesia using the GORE TAG endovascular graft. The stent graft was implanted at zone 3 through the left femoral artery using percutaneous technique. Perioperative aortography revealed the expansion of the stenotic lesion and the no endoleaks of the aneurysm. The pressuregradient between the upper and lower limbs decreased from 80 mmHg to 30 mmHg in systole and from 30 mmHg to 7 mmHg in mean. The ABI increased up to 1.03 on the right and 1.01 on the left. The patient was discharged the day after the surgery. Postoperative contrast-enhanced CT showed no endoleaks and expansion of the stenotic lesion. No postoperative complications were occurred. Although standard treatment for aortic coarctation is an open surgery, thoracic endovascular aortic repair is safe, minimally invasive and is one of the feasible options for the treatment of adult aortic coarctation.