급성 폐부종을 동반한 성인 대동맥 축착증 환자에서 성공적으로 시행하였던 응급 스텐트 삽입술
A successful stenting of the coarctation of aorta in a patient with acute pulmonary edema
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초록
대동맥축착증의 치료는 수술적 요법, 경피적 풍선확장술, 스텐트 삽입술 등 그 방법이 점차 발전되어 왔으며, 최근에는 스텐트 삽입술의 기술적 향상으로 수술적인 위험과 풍선확장술의 재협착의 빈도를 줄일 수 있게 되었다. 본 환자의 경우 폐부종을 동반한 울혈성 심부전으로 호흡부전까지 발생하였으나. 즉각적인 스텐트 삽입술을 시행하여 심부전의 호전과 고혈압의 완치를 보였다.
Abstract
Coarctation of aorta is a rare vascular disorder which is one of causes of secondary hypertension. Since the early 1990s stenting in the coarctation of aorta has been introduced as an alternative treatment method, there were a few cases which were treated by stent implantation for the coarctation of the aorta in Korea. But the case which was treated using stent in congestive heart failure with pulmonary edema has never been reported. We report on successful management of a 64-year-old female patient, who presented with acute heart failure and pulmonary edema due to severe aortic coarctation. After endotracheal intubation, aortogram was performed, which revealed a severe narrowing in the distal thoracic aorta with a peak systolic pressure gradient of 100 mmHg across the lesion. Stent implantation was performed with 24×100 mm self-expandable Nitinol-S stent after predilation with 10×40 mm balloon. After stenting, patient's symptom and sign of congestive heart failure were remarkably improved and endotracheal intubation tube was able to be removed. And no significant adverse cardiac events observed during a nine-month clinical follow-up.(Korean J Med 70:216-220, 2006)
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