Three Stage Hybrid Approach for Congenital Aortic Coarctation and Bicuspid Aortic Valve With Severe Aortic Stenosis in an Adult Patient

Abstract

Introduction: Untreated congenital aortic coarctation and valvular abnormalities are rare in an adult patient and require complex management. Report: A 68 year old woman with congenital aortic coarctation and bicuspid aortic valve with severe aortic stenosis is described. She was treated by a two week, staged, hybrid approach: (i) aortic valvuloplasty, (ii) endovascular aortic repair and (iii) surgical aortic valve replacement with tricuspid ring annuloplasty and left atrial appendage ligation. Two and six month follow up blood pressure measurements demonstrated improved control. Six month imaging showed a patent aortic stent graft. Discussion: A three stage, hybrid approach is a viable method for treating concomitant aortic coarctation and valvular heart disease in a symptomatic adult patient. Keywords: Aortic stenosis, Bicuspid aortic valve, Coarctation of aorta, Endovascular aortic repair, Hybrid repair