ABC | Volume 114, Nº4, Suplement, April 2020

Clinicoradiological Correlation Arq Bras Cardiol 2020; 114(4Suppl.1):38-39 Atik et al. Severe coartation of aorta in percutaneous treatment implanted. New angiographies showed a clear improvement in aortic coarctation (Figure 2). Posterior pressures were equivalent in the ascending and descending aorta at 127/67 and mean of 87 mmHg. Comments: Coarctation of the aorta, even when accentuated, can have a long-term evolution without significant changes, as long as collateral circulation develops to minimize aortic obstruction. This thought is in opposition with the evolution observed in this case, which did not develop even myocardial hypertrophy or some degree of myocardial dysfunction. Another aspect that draws attention in this clinical case was the late diagnosis of the anomaly, when a high blood pressure in the upper limbs was incidentally observed. This fact shows that the previous clinical examination of this patient had certainly not been performed with the refinements of a more adequate semiology. The percutaneous procedure has become the most indicated in the coarctation of the aorta, especially in young individuals and adults, due to fewer complications and similar effectiveness to that of the surgical procedure. 1,2 Angiographic images demonstrate this assertion. Figure 1 – PA Chest X-ray highlights normal cardiac area with a cardiothoracic index of 0.50 and normal pulmonary vascular network. Stent placement at the beginning of the descending aorta highlights post-stenotic dilation of the aorta. Figure 2 – Cardiac angiography shows the accentuated coarctation of the aorta, approximately 40 mm after the emergence of the left subclavian artery in the image on the left and the wide dilation of this region after stent placement in the image on the right. 1. Farag ES, Kluin J, de Heer F , et al. Aortic coarctation repair through left thoracotomy: results in the modern era. Eur J Cardiothorac Surg. 2019; 55(2): 331-7. 2. Erben Y, Oderich GS, Verhagen HJM, et al. Multicenter experience with endovascular treatment of aortic coarctation in adults. J Vasc Surg. 2019; 69(3): 671-9. References This is an open-access article distributed under the terms of the Creative Commons Attribution License 39