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Ann Thorac Surg 2002;74:973
© 2002 The Society of Thoracic Surgeons

Correspondence

Coarctation of the lower thoracic aorta

Fernando Amaral, MDa, Paulo J.F. Ribeiro, MDa, Helio C. Salgado, MDa

a Hospital do Coração de Ribeirão, Preto-Fundação Waldemar B Pessoa, Department of Physiology, Medical School of Ribeirão Preto, USP and UNAERP Medical School, Ribeirão Preto, Brazil

e-mail: ftvamaral{at}bol.com.br

To the Editor

We read with great interest the article by Neirotti and colleagues describing the interesting and well-documented case of a 3-month-old baby in heart failure due to severe congenital coarctation of the distal thoracic aorta [1].

The references mentioned in the above article are mostly related to abdominal aortic coarctation. Despite its rarity, this curious location of an obstruction was first described in 1835, according to Abbott [2]. As far as we know, there were only 12 cases published by 1993, when we described the case of a young man successfully operated on for this lesion [3]. In our case, a high index of suspicion of coarctation and an unobstructed aorta during cross-sectional echocardiography led to cardiac catheterization. During the procedure, a classic coarctation was not found. The obstruction was located after a second contrast injection in the lower thoracic aorta.

We agree with Dr Neirotti and associates when they say that the whole aorta should be assessed echocardiographically, especially when coarctation is clinically suspected and not found at its usual site.

References

  1. Neirotti R.A., Malcom D.D., Sugiyama G.T., Fosse G.R. Unusual form of coarctation of the distal thoracic aorta. Ann Thorac Surg 2001;72:1395-1396.[Abstract/Free Full Text]
  2. Abbott M.E. A statistical study and historical retrospect of 200 recorded cases of stenosis or obliteration of the descending arch in subjects above the age of 2 years. Am Heart J 1928;3:574-612.
  3. Amaral F.T.V., Ribeiro P.J.F., Salgado H.C. Congenital coarctation of the lower thoracic aorta. A rare surgically correctable cause of hypertension in the young—case report. Int J Cardiol 1993;39:109-111.[Medline]




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