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CLINICAL DATA The case of an 11-year-old girl weighing 33 kg is reported. Since birth she suffered from dyspnea and crying during breastfeeding. At 6 years of age she was submitted to repair of a perimembranous ventricular septal defect using a pericardium patch. Two months after, she suffered a significant pericardial effusion requiring another intervention for drainage. At 8 years of age, she started suffering from repeated headaches and high arterial pressure; aortic coarctation with a mean gradient of 108 mmHg was diagnosed at echocardiography. She underwent a cineangiography which located coarctation across the subclavian artery root and identified moderate aortic arch hypoplasia. In October 2006, she was admitted to hospital with acute ruptured appendicitis, peritonitis and sepsis. She evolved in a state of glomerulonephritis and three positive blood cultures showed oxacillin-sensitive Staphylococcus aureus. An echocardiographic investigation demonstrated bacterial endocarditis with vegetation adhered to the septal wall of the right ventricle. She responded well to antibiotic treatment. At preoperative physical examination she presented asymptomatic taking captopril and furosemide. Her heart rhythm was regular with a heart rate of 64 bpm, systolic murmur of ++/4+ at an accessory aortic focus. The lungs were clear. The abdomen was unaltered but with scarring. The arterial pressure was 120 x 70 mmHg (right arm) and 100 x 60 mmHg (Left arm) and 50 x 20 mmHg at (Lower limbs). Case 4/2007

Case 4/2007 - Aortic coarctation: Insertion of a tubular graft for post-endocarditis aneurysm.