JACC Case Rep. 2025 Dec 11:106405. doi: 10.1016/j.jaccas.2025.106405. Online ahead of print.
ABSTRACT
BACKGROUND: Infective aortitis is a rare complication following coarctoplasty. Unrecognized concomitant congenital defects such as patent ductus arteriosus (PDA) could be devastating.
CASE SUMMARY: We describe a young woman presenting with constitutional symptoms, elevated inflammatory markers, and a history of coarctoplasty with stent a decade earlier. Imaging revealed a large previously overlooked PDA and an aortic pseudoaneurysm distal to the stent covered by vegetations. Positron emission tomography/computed tomography demonstrated metabolically active lesions within the pulmonary artery and spleen. Broad-spectrum antibiotics, surgical stent excision, pseudoaneurysm repair with homograft, and PDA ligation achieved favorable outcomes with no residual infection on follow-up.
DISCUSSION: Sophisticated diagnostic modalities and a multidisciplinary approach are essential in rare, life-threatening complications. With growing use of endovascular therapies for aortic coarctation, awareness of uncommon complications and their management is crucial.
TAKE-HOME MESSAGES: A comprehensive preprocedural assessment to detect coexisting anomalies is essential. Multimodality imaging is key for diagnosis, treatment planning, and follow-up. Combined antibiotic therapy and surgical intervention ensured complete recovery.
PMID:41384901 | DOI:10.1016/j.jaccas.2025.106405