Case Report
Volume 9 Issue 4 - 2022
Premature Balloon Rupture During Stent Implantation for Aortic Re-Coarctation - Nightmare Case
P Syamasundar Rao*
Professor of Pediatrics and Medicine, Emeritus Chief of Pediatric Cardiology, Children’s Heart Institute, University of Texas-Houston McGovern Medical School, Children’s Memorial Hermann Hospital, Houston, Texas, USA
*Corresponding Author: P Syamasundar Rao, Professor of Pediatrics and Medicine, Emeritus Chief of Pediatric Cardiology, Children’s Heart Institute, University of Texas-Houston McGovern Medical School, Children’s Memorial Hermann Hospital, Houston, Texas, USA.
Received: May 23, 2022; Published: May 29, 2022


Coarctation of the aorta is a congenital heart defect (CHD) consisting of narrowing of the descending aorta and comprises 5 to 8% of all CHDs. Native coarctations are treated either with surgery or balloon angioplasty depending upon on the age at which they present and institutional preferences. Re-coarctations occur both with surgical and balloon therapy. Both post-surgical and post-balloon re-coarctations in adolescents and adults are largely dealt with stent implantation across the re-coarctation site. In this report we present a case in which the balloon ruptured during the stent implantation with resultant non-expansion of the stent. This case report consists of how to address such a complication. The objective is to implant the stent at the intended site and such objective was achieved in this case and details of the procedure were enumerated. The conclusion was that the interventionalist should take every effort to place the stent at the intended site and that this complication is unlikely to occur following the use of BIB catheters to implant stents.

Keywords: Coarctation of the Aorta; Stent; Balloon Rupture; Balloon Angioplasty


  1. Rao PS. “Coarctation of the aorta”. In: Secondary Forms of Hypertension, Ram CVS (ed), Seminars in Nephrology, Kurtzman NA (ed), W.B. Saunders, Philadelphia, PA 15.2 (1995): 81-105.
  2. Rao PS. “Coarctation of the aorta”. Current Cardiology Reports 6 (2005): 425-434.
  3. Rao PS. “Coarctation of the aorta”. Medscape Reference (2018).
  4. Tynan M., et al. “Balloon angioplasty for treatment of native coarctation: Results of Valvuloplasty and Angioplasty of Congenital Anomalies Registry”. American Journal of Cardiology 11 (1990): 790-792.
  5. Rao PS. “Balloon angioplasty of native aortic coarctation”. In. Rao PS (ed): Transcatheter Therapy in Pediatric Cardiology, Wiley-Liss, New York, NY (1993): 153-196.
  6. Rao PS. “Should balloon angioplasty be used instead of surgery for native aortic coarctation? (Editorial)”. British Heart Journal 6 (1995): 578-579.
  7. Rao PS. “Stents in the management of congenital heart disease in the pediatric and adult patients”. Indian Heart Journal 6 (2001): 714-730.
  8. Forbes TJ., et al. “Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta: an observational study by the CCISC (Congenital Cardiovascular Interventional Study Consortium)”. Journal of the American College of Cardiology 25 (2011): 2664-2674.
  9. Kan JS., et al. “Treatment of restenosis of coarctation by percutaneous transluminal angioplasty”. Circulation 5 (1983): 1087-1094.
  10. Rao PS. “Balloon angioplasty of aortic recoarctation following previous surgery”. In: Rao PS (ed): Transcatheter Therapy in Pediatric Cardiology, Wiley-Liss, New York, NY (1993): 197-212.
  11. Rao PS., et al. “Immediate and follow-up results of balloon angioplasty of postoperative recoarctation in infants and children”. American Heart Journal 6 (1990): 1315-1320.
  12. Siblini G., et al. “Long-term follow-up results of balloon angioplasty of postoperative aortic recoarctation”. American Journal of Cardiology 1 (1998): 61-67.
  13. Reich O., et al. “Long-term (up to 20 years) results of percutaneous balloon angioplasty of recurrent aortic coarctation without use of stents”. European Heart Journal 16 (2008): 2042-2048.
  14. Diethrich EB., et al. “Endovascular techniques in adult aortic coarctation: The use of stents for native and recurrent coarctation repair”. Journal of Endovascular Surgery2 (1995): 183-188.
  15. Harrison DA., et al. “Endovascular stents in the management of coarctation of the aorta in the adolescent and adult: One year follow up”. Heart 5 (2001): 561-566.
  16. Erdem A., et al. “Cheatham-Platinum stent for native and recurrent aortic coarctation in children and adults: Immediate and early follow-up results”. Anadolu Kardiyoloji Dergisi 5 (2011): 441-449.
  17. Rao PS. “Percutaneous management of aortic coarctation”. In. Vijayalakshmi IB, Ed. Cardiac Catheterization and Imaging (From Pediatrics to Geriatrics), Jaypee Publications, New Delhi, India (2015): 433-471.
  18. Rao PS., et al. “Balloon dilatation for discrete subaortic stenosis: Immediate and intermediate-term results”. Journal of Invasive Cardiology 2 (1990): 65-71.
  19. Sahu R and Rao PS. “Transcatheter stent therapy in children: An update”. Pediatrics and Therapeutics S5 (2012): 001.
  20. Suarez de Lezo J., et al. “Balloon expandable stent repair of severe coarctation of the aorta”. American Heart Journal 5 (1995): 1002-1008.
  21. Magee AG., et al. “Stent implantation for aortic coarctation and re-coarctation”. Heart 5 (1999): 600-606.
  22. Hamdan MA., et al. “Endovascular stents for coarctation of the aorta: Initial results and intermediate-term follow-up”. Journal of the American College of Cardiology 5 (2001): 1518-1523.
  23. Amirghofran AA., et al. “A wandering stent in the ascending aorta”. Journal of Cardiovascular Medicine (Hagerstown) 9 (2008): 969-970.
  24. Thanopoulos B., et al. “Long segment coarctation of the aorta: Treatment with multiple balloon-expandable stent implantation”. American Heart Journal4 (1997): 470-473.
  25. Marshall AC., et al. “Early results and medium-term follow-up of stent implantation for mild residual or recurrent aortic coarctation”. American Heart Journal6 (2000): 1054-1060.
  26. Rohit MK., et al. “Stent fracture after stent therapy for aortic coarctation: Nightmares in invasive cardiology”. Indian Heart Journal1 (2007): 77-79.
  27. Suarez de Lezo J., et al. “Immediate and follow-up findings after stent treatment for severe coarctation of the aorta”. American Journal of Cardiology 3 (1999): 400-406.
  28. Golden AB and Hellenbrand WE. “Coarctation of the aorta: Stenting in children and adults”. Catheterization and Cardiovascular Interventions 2 (2007): 289-299.
  29. Rao PS., et al. “Clinical comparison of rigid with flexible stents in the management of vascular obstructive lesions in children”. Poster Presentation at the Annual Scientific Meeting of Society of Cardiac Angiography and Interventions, May, 2003. Catheterization and Cardiovascular Interventions 59 (2003): 153.
  30. Rao PS. “Stents”. In. Rao PS. Pediatric Cardiology: How It Has Evolved Over The Last 50 Years. Cambridge Scholars Publishing, New Castle upon Tyne, ISBN 13: 9781527548886 (2020): 510-559.
Citation: P Syamasundar Rao. “Premature Balloon Rupture During Stent Implantation for Aortic Re-Coarctation - Nightmare Case”. EC Cardiology 9.4 (2022): 38-45.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.