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J Thorac Cardiovasc Surg 2005;130:1039-1043
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Endovascular repair of aneurysm after previous surgical coarctation repair

^a Division of Vascular Surgery, University of Cologne, Cologne, Germany.
^b Department of Radiology, University of Cologne, Cologne, Germany.

Received for publication March 31, 2005; revisions received May 23, 2005; accepted for publication May 26, 2005.

^_* Address for reprints: Michael Gawenda, MD, Associate Professor, Division of Vascular Surgery, Medical Centre, University of Cologne, Germany, Kerpener Str. 62, 50924 Cologne, Germany. (Email: Michael.gawenda{at}uk-koeln.de).

OBJECTIVES: Late aneurysm formation has been reported after every type of surgical coarctation repair, with rupture of such aneurysms being responsible for approximately 7% of all deaths. Secondary surgical repair carries a significant mortality and morbidity. According to the positive experience with endovascular therapy of atherosclerotic thoracic aortic aneurysms, it is worthwhile to evaluate the concept of minimally invasive endovascular stent grafting for secondary repair of postsurgical aneurysms.

METHODS: Data were collected prospectively on consecutive patients who presented with postcoarctation false aneurysms.

RESULTS: Since 1999, in a cohort of 46 endovascularly treated patients with thoracic aortic pathologies, 3 patients with postcoarctation false aneurysms underwent endoluminal stent-graft placement. All of these procedures were technically successful without 30-day or 1-year procedure-related mortality. After a mean follow-up of 19 months (range, 7.8-33.5 months), all aneurysm remain excluded without endoleak.

CONCLUSIONS: According to the current limited experience of small series and short periods of follow-up, the endoluminal repair seems to be a promising alternative to redo operations for postsurgical thoracic aneurysms associated with coarctation repair. Long-term follow-up is required to assess the durability of the stent-graft treatment.

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