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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BMC
2025-06-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03499-3 |
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| author | Siping Peng Tao Hu |
| author_facet | Siping Peng Tao Hu |
| author_sort | Siping Peng |
| collection | DOAJ |
| description | 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. |
| format | Article |
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| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| spelling | doaj-art-fa1b4271fba3413b8d96c4d5aab5bc992025-08-20T02:30:59ZengBMCJournal of Cardiothoracic Surgery1749-80902025-06-012011710.1186/s13019-025-03499-3Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case reportSiping Peng0Tao Hu1Department of Cardiology, Jiangxi Pingxiang People’s HospitalDepartment of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeAbstract 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.https://doi.org/10.1186/s13019-025-03499-3Congenital abdominal aortic coarctationAdolescent refractory hypertensionBalloon angioplastyVascular remodeling |
| spellingShingle | Siping Peng Tao Hu Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report Journal of Cardiothoracic Surgery Congenital abdominal aortic coarctation Adolescent refractory hypertension Balloon angioplasty Vascular remodeling |
| title | Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report |
| title_full | Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report |
| title_fullStr | Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report |
| title_full_unstemmed | Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report |
| title_short | Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report |
| title_sort | stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation a case report |
| topic | Congenital abdominal aortic coarctation Adolescent refractory hypertension Balloon angioplasty Vascular remodeling |
| url | https://doi.org/10.1186/s13019-025-03499-3 |
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