Related Experiment Video

Updated: Jul 8, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Endovascular treatment of aortic coarctation: long-term effects on hypertension

Carmine Musto1, Alberta Cifarelli, Edoardo Pucci

  • 1Interventional Cardiology Unit, S. Camillo/Forlanini Hospital, Circonvallazione Gianicolense, 87, 00151 Rome, Italy.

International Journal of Cardiology
|January 1, 2008
PubMed

Insights

Endovascular treatment for aortic coarctation (CoA) is safe in adolescents and adults, but 33% experienced persistent hypertension. Long-term monitoring, including exercise tests, is crucial for managing blood pressure after CoA repair.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Aortic coarctation (CoA) management via endovascular techniques is established as safe.
  • Limited data exist on the long-term efficacy of endovascular CoA treatment in resolving hypertension.
  • Adolescent and adult patients with CoA require evaluation for long-term outcomes after endovascular intervention.

Purpose of the Study:

  • To assess the immediate and long-term clinical and hemodynamic outcomes of endovascular treatment for aortic coarctation (CoA) in adolescent and adult patients.
  • To evaluate the effectiveness of endovascular CoA repair in managing hypertension.
  • To determine the safety and durability of transcatheter interventions for CoA.

Main Methods:

  • A consecutive series of 21 adolescent and adult patients with CoA underwent successful transcatheter intervention.
  • Follow-up included cardiological examinations, blood pressure (BP) assessment, echocardiography, 24-hour ambulatory BP monitoring (ABP), exercise testing, and spiral computed tomography.
  • Hemodynamic parameters, including CoA diameter, stenosis degree, and Doppler gradient, were measured pre- and post-intervention.

Main Results:

  • Successful endovascular repair significantly reduced CoA diameter and stenosis, with Doppler gradients decreasing from 58.8+/-16.9 to 10.5+/-4.9 mmHg (p<0.001).
  • Left ventricular mass also decreased post-intervention (p<0.001).
  • Despite treatment, 33% of patients (7/21) exhibited persistent hypertension at follow-up, with 14% hypertensive on ABP monitoring and 22% showing pathological BP response during exercise tests. The mean number of antihypertensive medications decreased from 1.5 to 0.5 (p<0.05).

Conclusions:

  • Endovascular treatment for native or recurrent aortic coarctation in adolescents and adults is a safe procedure.
  • A significant proportion (33%) of patients experience persistent hypertension post-intervention, underscoring the need for lifelong monitoring.
  • Meticulous clinical follow-up, including exercise testing, is essential to monitor blood pressure response and assess effort tolerance in patients treated for CoA.
Abstract

Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...