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(Circulation. 2004;109:e176.)
© 2004 American Heart Association, Inc.

Images in Cardiovascular Medicine

Multislice Computed Tomography for the Evaluation and Follow-Up of Stenting of Aortic Coarctation

Filippo Cademartiri, MD; Robert-Jan van Geuns, MD, PhD; Koen Nieman, MD, PhD; Folkert Meijboom, MD; Pim J. de Feyter, MD, PhD

From the Department of Radiology (F.C., K.N., P.J.d.F.), Erasmus Medical Center, Rotterdam, the Netherlands, and the Department of Cardiology (R.-J.v.G., K.N., F.M., P.J.d.F.), Thoraxcentrum, Erasmus Medical Center, Rotterdam, the Netherlands.

Correspondence to Filippo Cademartiri, MD, Department of Radiology, Erasmus Medical Center, Rotterdam, Dr. Molenwaterplein, 40, 3015 GD, Rotterdam, The Netherlands. E-mail filippocademartiri{at}hotmail.com

A 58-year-old woman with congenital recurrent aortic coarctation and severe aortic valve stenosis underwent ECG-gated 16-row multislice computed tomography (MSCT) angiography (Sensation 16, Siemens) of the thorax for treatment planning (Figure, A and B; Movie I). The MSCT scan revealed 2 consecutive stenoses: the first immediately distal to the origin of the left subclavian artery (<50% diameter reduction), and the second at the level of the isthmus (>50% diameter reduction).

View larger version (110K): [in this window] [in a new window]   Evaluation, endovascular treatment, and follow-up of aortic coarctation with MSCT. The 16-row MSCT scan with volume-rendering reconstruction, performed for evaluation and treatment planning, shows the morphology of the aortic arch with the 2 stenoses (A and B). The first and more proximal one is located close (1 cm) to the origin of the left subclavian artery (A; thin arrow), whereas the second one is located at the level of the isthmus (A; thick arrow). The percutaneous interventional procedure for the positioning of the stent is shown in C and D. A follow-up MSCT scan with volume-rendering reconstructions performed after treatment shows the correct position of the stent (E and F). Ao indicates ascending aorta; LV, left ventricle; and PA, pulmonary artery.

On the basis of the risk of major surgery in this woman with severe aortic valve stenosis, we decided to stent (CP Stent; NuMed) the isthmic stenosis (Figure, C and D). During the procedure, the first stenosis was confirmed as hemodynamically less severe compared with the second one (16 mm Hg versus 50 mm Hg). After the procedure, the follow-up scan showed the correct position of the stent and its patency (Figure, E and F; Movie II). Then the patient underwent successful operative repair of her aortic valve stenosis.

Footnotes

Movies I and II are available in the online-only Data Supplement at http://www.circulationaha.org.

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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This Article Extract Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cademartiri, F. Articles by de Feyter, P. J. Search for Related Content PubMed PubMed Citation Articles by Cademartiri, F. Articles by de Feyter, P. J. Related Collections Imaging Other etiology CT and MRI