[Angioplasty and stenting in treatment of critical aortic coarctation]

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Medicine

Background:

• Native coarctation of the aorta is a congenital heart defect often presenting with significant hypertension.
• Endovascular treatment offers a less invasive approach compared to surgical repair.
• Previous treatments often involved medication or open surgery with associated risks.

Purpose of the Study:

• To evaluate the efficacy and outcomes of endovascular treatment for native coarctation of the aorta.
• To assess hemodynamic changes and blood pressure control post-intervention.
• To share experience with angioplasty and stenting in this patient population.

Main Methods:

• A cohort of seven patients with native coarctation of the aorta underwent endovascular treatment (angioplasty and stenting).
• Comprehensive pre-treatment evaluations included clinical history, ECG, X-rays, echocardiogram, and angiography.
• Patients were managed for hypertension, often requiring one to two antihypertensive medications prior to treatment.

Main Results:

• Successful endovascular treatment in all seven patients, with a significant reduction in the average trans-coarctation gradient from 80 mm Hg to 4 mm Hg.
• Marked improvement in blood pressure control, with only three patients requiring continued antihypertensive medication post-procedure.
• Aortic insufficiency was observed in four patients but improved following the endovascular intervention.

Conclusions:

• Endovascular treatment, including angioplasty and stenting, is a viable option for native coarctation of the aorta.
• Pre-dilation of the coarctation lesion prior to stent deployment may be beneficial, especially in critical cases.
• The procedure leads to significant hemodynamic improvement and better blood pressure management.