TEVAR in patients with late complications of aortic coarctation repair.
OBJECTIVE
To review the use of thoracic endovascular aortic repair (TEVAR) for late pseudoaneurysm formation after surgical repair of aortic coarctation.


METHODS
From May 2001 to May 2005, 8 patients (5 men; mean age 47.6 years, range 18-73) with a history of aortic coarctation repairs 17 to 40 years prior were referred to our institution for an anastomotic thoracic pseudoaneurysm. TEVAR was performed successfully in 7 patients; 1 died of suspected aneurysm rupture before the scheduled procedure. A carotid-subclavian bypass was performed in 3 patients.


RESULTS
All the procedures were immediately successful. No type I endoleaks were seen on the final control angiogram, but 2 of the patients with carotid-subclavian bypasses required additional left subclavian artery embolization due to type II endoleak. One of these patients died before embolotherapy on the 5th postoperative day from presumed aneurysm rupture (14% 30-day mortality rate). Over a follow-up period ranging from 15 to 72 months (mean 37), all the false aneurysms have remained thrombosed and the mean diameter has decreased from 44 to 23 mm. No endograft-related complications have occurred, and no further interventions have so far been necessary.


CONCLUSIONS
TEVAR is a feasible alternative treatment for patients who have already undergone surgical repair of aortic coarctation. Technical issues regarding the endovascular strategy should be discussed with a multidisciplinary team to define the correct interventional plan.
Department of Cardiovascular Imaging and Radiology, Hôpital Cardiologique, CHRU de Lille, France.
Marco
M
Midulla
Aurelie
A
Dehaene
François
F
Godart
Christophe
C
Lions
Christophe
C
Decoene
Willoteaux
W
Serge
Mohamad
M
Koussa
Christian
C
Rey
Alain
A
Prat
Jean-Paul
JP
Beregi
D000293:Adolescent; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000601:surgery*; D001013:Aorta, Thoracic; D001017:Aortic Coarctation / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods; D055815:Young Adult