Related Experiment Video
Updated: Aug 18, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Percutaneous interventions on severe coarctation of the aorta: a 21-year experience
J Suárez de Lezo1, M Pan, M Romero
1Department of Cardiology, University Hospital, Reina Sofia, Avda. Menéndez Pidal 1 14004, Córdoba, Spain. grupo_corpal@arrakis.es
Insights
Percutaneous interventions for coarctation of the aorta show promising long-term results, with varying success rates and complication profiles across different patient groups and treatment methods. Long-term survival is achievable, but reintervention rates highlight the need for ongoing management.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Coarctation of the aorta is a congenital heart defect requiring intervention.
- Percutaneous techniques offer treatment options, but long-term outcomes require further elucidation.
- This review examines 21 years of experience with percutaneous treatment for coarctation of the aorta.
Purpose of the Study:
- To review the long-term outcomes of percutaneous interventions for coarctation of the aorta.
- To analyze results across four distinct treatment scenarios.
- To evaluate survival rates, need for reintervention, and complication development.
Main Methods:
- Retrospective review of 21 years of percutaneous interventions for coarctation of the aorta.
- Categorization into four groups based on patient age and intervention type (balloon angioplasty vs. stenting).
- Long-term follow-up including clinical assessment, hemodynamic, and angiographic studies.
Main Results:
- Balloon angioplasty in infants had a high initial mortality (17%) but good long-term survival (83% at 19 years) with significant reintervention needs (43% surgery-free, 23% reintervention-free).
- Balloon angioplasty in children/adults showed better long-term relief in discrete coarctation, with 6% late aneurysm formation.
- Stent palliation in young children required further expansion and had risks of intrastent proliferation (18%) and aneurysm (18%).
- Stent repair in older children/adults demonstrated significant and persistent relief, with low mortality (1.3%) and no late restenosis or aneurysms at 5-year follow-up.
Conclusions:
- Percutaneous treatment for coarctation of the aorta yields variable long-term results depending on patient age and intervention strategy.
- While initial outcomes can be excellent, particularly with stenting in older patients, long-term surveillance is crucial for managing potential complications like restenosis and aneurysm formation.
- Stent palliation in young children necessitates careful management to accommodate growth and prevent complications, which are often treatable percutaneously.
Abstract:
Different percutaneous interventions can be used to treat coarctation of the aorta. However, a great amount of information is still needed regarding the long-term course. This article reviews our experience spanning 21 years in the percutaneous treatment of aortic coarctation. Four different conditions for treatment were considered. The first condition 1 (group 1) was balloon angioplasty in neonates and infants with untractable heart failure (n = 54; mean age, 1.2 +/- 1.4 months). After balloon angioplasty, most infants sustained significant clinical improvement. However, 9 patients died in the hospital (17%). As a result, we monitored the course of the 45 survivors during a mean period of 10 +/- 6 years (range, 1-19). During this follow-up period, 17 patients needed a single additional intervention on coarctation (8 underwent surgery and 9 were treated percutaneously). After this second treatment, 11 patients needed one or more further interventions. The actuarial survival probability was 83% at 19 years, with 43% of patients remaining surgery free and 23% reintervention free. The second condition (group 2) was balloon angioplasty in children and adults with coarctation of the aorta before the stenting era (n = 28; mean age, 13 +/- 8 years). After treatment, serial hemodynamic and angiographic studies were performed. The long-term relief was higher in patients with a discrete type of coarctation. The rate of late aneurysm formation was 6%. The third condition (group 3) was stent palliation in infants and children younger than the age of 6 years (n = 17; mean age, 2.1 +/- 1.7 years). The stent was implanted for nondilatable stenoses, as a nondefinitive procedure. Stent palliation provides complete initial relief in hypoplastic coarctations or life-threatening conditions. However, further stent expansion is required to ensure adequate stent diameter in the growing aortic wall. In addition, late intrastent proliferation may occur in small stent diameters (18%) and aneurysm formation in hypoplastic coarctations (18%). Both late complications can be managed percutaneously. The fourth condition (group 4) was stent repair of severe aortic coarctation in adults, adolescents, and children older than the age of 6 years (n = 73; mean age, 20 +/- 12 years). Significant relief was observed after treatment, which persisted at follow-up. One patient died at treatment (1.3%). After a mean follow-up of 5 +/- 3 years, all 72 patients remained symptom free and no restenosis or late aneurysm were detected.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care