-2 :: Case - 7985 :: - Aortic coarctation repair; postsurgical imaging
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Tx and Followup:
Patient will receive continued imaging and clinical follow-up; she is currently asymptomatic.

Additional Discussion:
Please see factoid.

Discussion Author: Jason Rexroad

Magnetic resonance imaging (MRI) plays an important role in the postoperative evaluation of aortic coarctation repair. Coarctation of the aorta can be treated with resection and anastamosis, patch grafts, tube grafts, or use of catheter-based techniques. Restenosis/late recoarctation and pseudoaneurysms are the most common postoperative complications which can be demonstrated by MR examination (1). Aneurysm formation is most commonly seen opposite the side of patch replacement, and the risk of rupture is high when the ratio between dilated aorta to the diaphragmatic aorta is greater than 1:1.5. Velocity-encoded studies can be used to determine the pressure differential across a region of stenosis at the site of repair, with a value greater than 20mm Hg likely to represent a significant gradient (2). Additionally, images should be examined for the presence of a stenotic jet at the site of repair.

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