JACC. Case reports · 2026
The Calcified Barrier: A Rare Cause of a Distal Aortic Arch Stenosis.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gottsberger J, Huber F, Szalkiewicz P, Schachner B, Zierer A
Аннотация
BACKGROUND: Calcification of the aortic arch is common, but an intraluminal calcified plaque causing functional stenosis is rare. At the distal arch, it mimics aortic coarctation, with refractory upper-body hypertension and left ventricular pressure overload.
CASE SUMMARY: A 61-year-old man presented with refractory hypertension despite 4 agents and recurrent hypertensive cardiac decompensation with an upper-to-lower-limb blood pressure gradient. Computed tomography angiography showed a high-grade calcified stenosis of the distal arch (peak gradient 70 mm Hg; left ventricular ejection fraction 30%). The lesion was resected en bloc and the arch reconstructed with a frozen elephant trunk prosthesis under selective cerebral perfusion. Recovery was uneventful; the gradient resolved and left ventricular ejection fraction improved to 45% at 6 months.
DISCUSSION: Coral reef obstruction of the arch is rare, lacks management guidelines, and is easily mistaken for congenital coarctation or Takayasu arteritis.
TAKE-HOME MESSAGE: When rigid calcification precludes endovascular therapy, en bloc resection with frozen elephant trunk reconstruction offers a safe and durable repair.
CASE SUMMARY: A 61-year-old man presented with refractory hypertension despite 4 agents and recurrent hypertensive cardiac decompensation with an upper-to-lower-limb blood pressure gradient. Computed tomography angiography showed a high-grade calcified stenosis of the distal arch (peak gradient 70 mm Hg; left ventricular ejection fraction 30%). The lesion was resected en bloc and the arch reconstructed with a frozen elephant trunk prosthesis under selective cerebral perfusion. Recovery was uneventful; the gradient resolved and left ventricular ejection fraction improved to 45% at 6 months.
DISCUSSION: Coral reef obstruction of the arch is rare, lacks management guidelines, and is easily mistaken for congenital coarctation or Takayasu arteritis.
TAKE-HOME MESSAGE: When rigid calcification precludes endovascular therapy, en bloc resection with frozen elephant trunk reconstruction offers a safe and durable repair.