Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
Abstract Background Congenital focal abdominal aortic coarctation (CAAC) is a rare vascular malformation frequently misdiagnosed as mid-aortic syndrome (MAS). A significant challenge in managing CAAC, particularly in young individuals, is addressing the coarctation while accommodating ongoing vascul...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-025-03499-3 |
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| Summary: | Abstract Background Congenital focal abdominal aortic coarctation (CAAC) is a rare vascular malformation frequently misdiagnosed as mid-aortic syndrome (MAS). A significant challenge in managing CAAC, particularly in young individuals, is addressing the coarctation while accommodating ongoing vascular growth and development. This case highlights the value of multidisciplinary collaboration and imaging-guided stentless balloon angioplasty in preserving vascular growth potential. Case presentation A 14-year-old male presented with a two-year history of refractory hypertension (peak:190/110mmHg) and exertional dizziness. Thoracoabdominal computed tomography angiography (CTA) revealed a focal coarctation (minimum luminal diameter: 4.2 mm, representing 70% stenosis) extending from the celiac artery origin to the superior mesenteric artery origin, without significant collateralization. Digital subtraction angiography (DSA)-guided balloon angioplasty (10 × 40 mm) resulted in a significant reduction of the transcoarctation pressure gradient from 45mmHg to 8mmHg, achieving normotension (120/80mmHg). At six-month follow-up, a 161% increase in aortic luminal diameter (to 11 mm) was observed, accompanied by complete regression of left ventricular hypertrophy (LVH), as evidenced by a decrease in interventricular septal thickness from 12 mm to 9 mm. Conclusions Stentless balloon angioplasty is an effective strategy in treating CAAC in adolescents, achieving both immediate hemodynamic relief and facilitating growth-adaptive aortic remodeling. Comprehensive aortic imaging is crucial for the diagnosis and management of refractory hypertension in adolescents. |
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| ISSN: | 1749-8090 |