COARCTATION OF AORTA MIMICKING AORTIC-ARCH INTERRUPTION AND ITS SUCCESSFUL DILATATION BY AN INNOVATIVE APPROACH

Balloon dilatation for coarctation of the aorta is an established alte rnative to surgery in older children and young adults with a high succ ess rate and a low incidence of restenosis.(1-4) However, balloon dila tation has to be performed with extreme caution when the coarct segmen t involves the major branches of the aortic arch or when the coarct ha s an atypical anatomy. Herein, we report an unusual case which was sug gestive of aortic arch interruption on descending thoracic aortography and could not be crossed retrogradely. Brachial approach for ascendin g aortography revealed that this was indeed a coarct with a distorted anatomy and also made possible crossing of the coarct antegradely. Aft er exteriorizing the guide wire across the coarct with the help of a s nare device advanced through the femoral arterial sheath, the coarct c ould be dilated from the femoral route as is routinely done.