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Concomitant percutaneous treatment of aortic coarctation and associated intercostal aneurysms: pre-procedural recognition is key

Published online by Cambridge University Press:  19 June 2015

Sarosh P. Batlivala  and
Jonathan J. Rome
Sarosh P. Batlivala*
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America Division of Pediatric Cardiology, Blair E. Batson Hospital for Children, Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Jonathan J. Rome
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: S. P. Batlivala, MD, Division of Pediatric Cardiology, Blair E. Batson Hospital for Children, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, United States of America. Tel: +601 984 5977; Fax: +601 984 5283; E-mail: sbatlivala@umc.edu
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Abstract

Intercostal aneurysms are associated with aortic coarctation. Their aetiology is not well-understood but may be related to intrinsic vascular pathology and altered flow dynamics through the intercostal artery. We present the cases of two patients with coarctation and intercostal aneurysms. The aneurysms were recognised on pre-catheterisation imaging studies and were selectively occluded during the same procedure to treat the coarctation. There were no complications; both the patients have no residual coarctation at the most recent follow-up. Intercostal aneurysms associated with coarctation can have significant consequences including late rupture, paralysis, and even death. These aneurysms are common with an incidence of up to 40% with adult-diagnosed coarctation; one treatment plan is to treat both the coarctation and aneurysm during a single catheterisation. Pre-catheterisation CT or MRI may play a role in this strategy.

Keywords

Coarctation of the aortacollateral arteriesaneurysmCHD
Type
Brief Reports
Information
Cardiology in the Young , Volume 26 , Issue 2 , February 2016 , pp. 390 - 395
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Copyright
© Cambridge University Press 2015 

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