Coarctation of the Aorta in an Adult Diagnosed by the Presence of Complete AV Block and Heart Failure
10.4326/jjcvs.37.247
- VernacularTitle:完全房室ブロック，心不全を契機に診断された成人大動脈縮窄症の1手術例
- Author:
Tadamasa Miyauchi
;
Katsuya Shimabukuro
;
Eiji Murakami
;
Yukiomi Fukumoto
;
Narihiro Ishida
;
Toshiki Hatsune
;
Hideaki Manabe
;
Hirofumi Takemura
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(4):247-251
- CountryJapan
- Language:Japanese
-
Abstract:
A 51-year-old woman, who had been undergoing regular treatment and follow-up for hypertension since the age of 17, was diagnosed to have a patent ductus arteriosus (PDA) 6 months previously. On experiencing dyspnea, she visited the emergency room, where she was found to have a complete Atrioventricular (AV) Block and therefore was immediately admitted. The next day, she experienced acute heart failure requiring intubation. A DDD pacemaker was then implanted and the patient recovered thereafter. After recovery, a screening contrast-enhanced CT scan revealed coarctation of the thoracic aorta. The arterial pressure gradient between the arms and legs was about 70mmHg. The division of the PDA and the replacement of the coarcted aortic segment were performed under femoro-femoral cardiopulmonary bypass through a left posterolateral thoracotomy. The patient's postoperative course was good, however, she complained of abdominal pain on the 6th postoperative day. An abdominal CT scan showed hemorrhage in the left rectus abdominus and right iliopsoas muscles. This improved after rest. No arterial pressure gradient was observed between the arms and the legs postoperatively. She was discharged on postoperative day 20.Because the average life expectancy of patients with untreated coarctation of the aorta has been reported to be about 34 years, it is recommended that surgical repair be performed as soon as possible. Patients with childhood-onset hypertension should therefore be evaluated to determine the primary disease whenever possible, such as coarctation of the aorta as in this case.
