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KMID : 0368119940240040681
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Korean Circulation Journal
1994 Volume.24 No. 4 p.681 ~ p.686
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Balloon Dilation Angioplasty of Aortic Coarctation in Adult
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조윤경
이용규/송광선/여경구/김준명/윤정한/박금수/최경훈
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Abstract
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A 21-year-old woman found to be hypertensive was referred for hypertension. On examination, blood pressure was 170/110mmHg in the right arm. 160/100mmHg in left arm, and 120/70mmHg in legs. A grade 2/6 systolic ejection murmur was present at the
left
upper sternal border, and a chest x-ray revealed a rib notching on the inferior margin of 4th left rib.
Two-dimensional echocardiogram showed the coarctation of aorta beyound the origin of the left subclavian artery. Biplane TEE demonstrated a diserete narrowing of the descending aorta at the site of coarctation.
The blood pressure was 169/86mmHg in ascending aorta and 118/84mmHg in descending aorta. Aortogram showed a localized coarcted aortic segment of 7m in diameter and 5mm long just distal to the left subclavian artery.
Balloon coarctation angioplasty was performed with 7F 30x 15mm pediatric balloon dilatation catheter. Balloon position was confirmed on fluoroscopy by the hourglass appearance of the balloon inflation and thereafter, the balloon was inflated
until
the
waist of the balloon disappeared.
After procedure, A pull back pressure tracing across the coarctation of aorta revealed no poressure gradient between ascending and descending aorta with 141/90mmHg. Aortogram showed an increase in diameter of the coartation of aorta to 18mm with
aneurysmal formation.
3 months later, follow up aortogram showed no significant change in diameter of coarctation of aorta of aneurysmal formation.
Nonsurgical balloon coarctation angioplasty appears to be an alternative therapy for the coarctation of aorta in adults.
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