Complication of aortic coarctation repair surgery

摘要

A 31-year-old man who had undergone aortic coarctation repair surgery at age 2 and re-do surgery at age 19, who was not receiving regular follow-up, was referred to a cardiology clinic with breathlessness on exercise. His cardiovascular examination identified aortic regurgitation, confirmed on transthoracic echocardiography as moderate, in association with a bicuspid aortic valve and normal left ventricular function. A cardiac magnetic resonance study showed a 3 cm long graft just distal to the left subclavian artery with an aneurysm between the proximal edge of the graft and the distal insertion point of the left subclavian artery (panel A; video 1), in addition to the bicuspid aortic valve (panel B; video 2) and significant aortic incompetence (regurgitant fraction of 40%) (video 3). The left ventricle was dilated but maintained good function.