선천성 승모판 협착증을 동반한 성인 대동맥축착의 스텐트 삽입술 1례

Abstract

Coarctation of aorta is a rare cause of secondary hypertension, and premature death will occur if no appropriate treatment is given. The only effective treatment was surgery before 1980, but restenosis was frequent. Several works on percutaneous transluminal angioplasty of the disease were reported. In patients with previously operated recoarctation, there is no doubt that balloon angioplasty is now the first choice of the therapy because of the surgical risks of reoperation. Nevertheless, there has still been some controversy regarding the applications of this therapy to native coarctation, because of the potential risk of aortic disruption and the high incidence restenosis. There have been some clinical reports of successfiil stent implantation for coarctation without ma complications since 1991. We report on our experience with balloon-expandable stent implantation for nazi coarctation of the aorta in a 23-year-old man with congenital mitral stenosis. Aortogram showed a coarct aortic segment of 3 mm in diameter and 25 mm long just distal to the left subdavian artery. The peak systo pressure gradient across the coarctation before stent implantation was 100 mmHg. Stent implantation w performed with 14 x 40 mm balloon with Palmaz P308 stent. The peak systolic pressure gradient decreased zero and the diameter of the coarctation of aorta increased to 14 mm after stent implantation immediately. The patient tolerated well and no significant complications were encountered during the procedure.