Impact of different coarctation therapies on aortic stiffness: phase-contrast MRI study

Coarctation of the aorta has been associated with increased thoracic aortic stiffness in adolescents and young adults. However, the effects of different therapeutic strategies on aortic stiffness in a young population is unknown. This study aimed to non-invasively assess aortic stiffness between different repair or intervention strategies in patients with coarctation of the aorta. Forty-nine coarctation patients who underwent either surgery (n = 26), balloon angioplasty (n = 14), or stent implantation (n = 12), and 26 age- and size-matched normotensive healthy controls underwent evaluation of thoracic aortic stiffness and flow hemodynamics via phase-contrast cardiac magnetic resonance. In children who had undergone surgical repair or balloon angioplasty, ascending aortic stiffness was increased when measured via pulse wave velocity (PWV) when compared to normal controls (all P < 0.05). Furthermore, ascending aortic distensibility and relative area change (RAC) was significantly lower in surgically and balloon treated groups (both P < 0.01). Stiffness (PWV), distensibility, and RAC in the ascending aorta were not statistically different between stented patients and controls. The ascending aorta of children following surgical repair or balloon angioplasty demonstrated signs of elevated stiffness, whereas those treated by stent implantation showed no difference in stiffness markers when compared to normal controls.