title: Hypertensive heart failure associated with middle aortic syndrome reversed dramatically by endovascular management.
abstract: A 42-year-old male patient presented with refractory hypertension and congestive heart failure. He had taken hydrochlorthiazide 50 mg, carvedilol 25 mg, diltiazem 180 mg, and losartan 100 mg per day. Aortogram revealed a severe luminal narrowing in the distal thoracic aorta with a peak systolic pressure gradient of 60 mmHg across the lesion. Endovascular management was performed with 22 × 80 mm self-expandable Nitinol-S stent after predilation with 10 × 40 mm balloon. After endovascular management, the patient's blood pressure, left ventricular ejection fraction (LVEF) and dilated LV dimension were remarkably improved.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea.
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Chung Su
authors.initials: CS
authors.lastname: Park
authors.forename: Hee Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyung Hwan
authors.initials: KH
authors.lastname: Kim
authors.forename: Hye Mi
authors.initials: HM
authors.lastname: An
authors.forename: Yeon Hwa
authors.initials: YH
authors.lastname: Kim
authors.forename: Chur Hoan
authors.initials: CH
authors.lastname: Lim
authors.forename: Won Yu
authors.initials: WY
authors.lastname: Kang
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Hwang
authors.forename: Wan
authors.initials: W
authors.lastname: Kim
references.citation: Heart. 2001 May;85(5):561-6
references.pmid: 11303011
references.citation: Int J Cardiol. 2004 Dec;97 Suppl 1:75-8
references.pmid: 15590082
references.citation: Int J Cardiol. 2006 Nov 10;113(2):267-9
references.pmid: 16298442
references.citation: Ann Vasc Surg. 1995 Jul;9(4):352-6
references.pmid: 8527335