Reversible left ventricular dysfunction due to severe stenosis of the elephant trunk graft: A case report

Eiji Anegawa, Takuya Watanabe, Yoshimasa Seike, Takanori Nishimura, Hiroki Mochizuki, Koichiro Yoshitake, Nobuichiro Yagi, Yasumori Sujino, Kensuke Kuroda, Seiko Doi, Osamu Seguchi, Masanobu Yanase, Manabu Matsumoto, Yoshihiko Ikeda, Hitoshi Matsuda, Norihide Fukushima

Research output: Contribution to journalArticlepeer-review

Abstract

Acquired coarctation of the aorta (CoA) following total aortic arch replacement (TAR) is a rare complication inducing left ventricular (LV) dysfunction probably due to increased LV afterload and secondary hypertension caused by increased upper body and decreased renal blood flow. We describe a case of a 35-year-old male who developed atypical CoA with severe LV dysfunction with LV ejection fraction of 10%, but without secondary hypertension after TAR using conventional elephant trunk (ET) technique for acute aortic dissection. Computed tomography revealed near-occlusive CoA due to narrowed distal ET. Because the myocardial histological findings were mild, and he had no cardiac failure history, we determined that LV function might be reversible. He underwent thoracic endovascular aortic repair (TEVAR), resulting in restored LV function. However, as the descending aortic false lumen distally to the end of ET was rapidly dilated, probably due to increased cardiac output and lower body blood flow, he underwent descending aortic replacement 3 months after TEVAR. In conclusion, a narrowed distal ET may cause LV dysfunction early after TAR, even without secondary hypertension. TEVAR may be a useful therapeutic option for a narrowed distant ET but can induce distal aortic dilatation.

Original languageEnglish
JournalJournal of Cardiology Cases
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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