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The coarctation of the aorta (CoA) is rare in adulthood. Diagnosis is made by clinical suspicion and physical findings such as blood pressure difference between the upper and lower extremities, pulse delay in the femoral artery, and systolic murmur over the thoracic spine.The CoA in adulthood and in patients with associated aneurysm is challenging and different complications even with proper treatment can occur. Covered stents are indicated in concomitant aneurysm, older age, and tight coarctation. A 26-year-old male with resistant hypertension due to a CoA diagnosed by computed tomography angiography referred to our center for an attempted stent implantation. Cardiac catheterization and aortography revealed a long CoA after the origin of the left subclavian artery with a 60 mmHg gradient. Moreover, there was a large aneurysm in the site of the coarctation. Under general anesthesia and fluoroscopic guidance, two balloon-expandable covered Cheatham-Platinum stents (size 18 in 44 millimeters and size 18 in 50 millimeters) were successfully implanted across the CoA with no residual gradient. On 2 years' follow-up, the patient had no symptoms except for mild hypertension. In this patient, the use of a covered stent within the aneurysm was safe and effective. [ABSTRACT FROM AUTHOR]

We describe the case of a man incidentally found to have a pseudoaneurysm of the ascending aorta at the site of a previously (12 years ago) implanted metallic prosthetic aortic valve. Transthoracic echocardiography and computed tomography images demonstrate the pseudoaneurysm. The patient has undergone surgical repair with a good result. [ABSTRACT FROM AUTHOR]

The coarctation of the aorta (CoA) is rare in adulthood. Diagnosis is made by clinical suspicion and physical findings such as blood pressure difference between the upper and lower extremities, pulse delay in the femoral artery, and systolic murmur over the thoracic spine. The CoA in adulthood and in patients with associated aneurysm is challenging and different complications even with proper treatment can occur. Covered stents are indicated in concomitant aneurysm, older age, and tight coarctation. A 26-year-old male with resistant hypertension due to a CoA diagnosed by computed tomography angiography referred to our center for an attempted stent implantation. Cardiac catheterization and aortography revealed a long CoA after the origin of the left subclavian artery with a 60 mmHg gradient. Moreover, there was a large aneurysm in the site of the coarctation. Under general anesthesia and fluoroscopic guidance, two balloon-expandable covered Cheatham-Platinum stents (size 18 in 44 millimeters and size 18 in 50 millimeters) were successfully implanted across the CoA with no residual gradient. On 2 years' follow-up, the patient had no symptoms except for mild hypertension. In this patient, the use of a covered stent within the aneurysm was safe and effective.

Coronary anomalies are rare congenital disorders with mostly benign course. We report a case of 54-year-old white male who was with stable angina scheduled for coronary angiography. Due to the difficulty of catheterization, patient underwent CT angiography and high take off left main and right coronary arteries were revealed. We conclude that anomalous coronary arteries are important and coronary interventions may be difficult in their presence.