Patient: I am 52 years old and in July 2003, I had a sudden onset of chest and abdominal pain, sweating profusely and almost fainting due to swimming in cold water (about 10 degrees) after drinking. I have not felt any discomfort since then.
In January 2008, he went to the hospital for a physical examination and was diagnosed with descending aortic coarctation by 64-level CT. The length of the clamping was from the posterior end of the aortic arch to the end near the renal artery, with openings above and below the clamping and blood flowing within. I have been taking two kinds of medications to control my blood pressure, Conexant (Bisoprolol Fumarate) and Nifedipine extended-release tablets.
Is it possible to treat this problem without surgery? What should I do to control the progression of the disease? What kind of medication should I take and what kind of intensity of exercise should I do? If surgical treatment is to be performed, when should I feel it?
Wuhan Union Medical College Hospital Cardiac Surgery Department Jiang Xionggang Wuhan Union Medical College Hospital Cardiac Surgery Department Jiang Xionggang: Aortic coarctation has lost the normal structure of the vessel wall, so there is a certain degree of possibility of rupture until the false lumen is completely occluded.
And for your current situation, after some necessary examinations, if appropriate, you can consider a minimally invasive method with the help of intervention to implant a stent by arterial puncture to close the vessel pseudolumen, thus playing a role in reinforcing the vessel wall. This method is less invasive, does not require open-heart surgery, and has a quick recovery, and you can always go to a hospital with relevant treatment capabilities as long as your condition allows.
As for exercise, avoid strenuous and excessive forceful items, and avoid impact on the chest and back, while other mild daily life and work will not be affected. Patient: Thank you, Dr. Jiang! Patient: The sandwich is too long, the inlet and outlet are widely spaced, one stent may not be able to block both the inlet and outlet, if only the inlet is blocked, will the blood flow backwards in through the other port?
In addition, after the stent is placed, is it a permanent solution? Do I have to take antihypertensive drugs for years to control blood pressure to avoid recurrence? Is there any risk of stenting? Thanks again! Jiang Xionggang, Department of Cardiac Surgery, Wuhan Union Hospital: Stent implantation is mainly for sealing the inlet, and the blood flow and blood pressure at the outlet are relatively low. After the inlet is closed, most of the blood flow in the false cavity is reduced and there is thrombus mechanization, and the outlet can be closed.
In a few cases, after stent implantation, the outlet is not finally closed, but it has little effect on health, and in rare cases, the outlet is transformed into the inlet and there is further development of the entrapment.
Therefore, even with stenting, blood pressure control and testing need to be continued.
There are some risks associated with stenting, but they are much lower than open-heart surgery, which has a higher mortality rate and much more difficult recovery.