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Transcatheter Endovascular Management of Complex Coarctation of the Aorta in Adults
Preeti Gahlan1, Rajesh Nair1, Faeez Mohamad Ali1
1Department of Cardiology, Waikato Hospital, Te Whatu Ora (Health New Zealand), Hamilton, Waikato, New Zealand.
Insights
Transcatheter interventions offer successful treatment for complex adult coarctation of the aorta (CoA). Advanced imaging and custom stenting facilitated positive outcomes in two challenging cases of aortic coarctation.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Coarctation of the aorta (CoA) in adults is a treatable cause of secondary or resistant hypertension, often diagnosed incidentally.
- Treatment options for adult CoA include surgical repair and transcatheter interventions.
Abstract:
Coarctation of aorta (CoA) in adults is often diagnosed incidentally during the work-up for secondary or resistant hypertension causes, making it one of the treatable causes of hypertension. Treatment options range from surgery to transcatheter interventions. We present 2 cases of complex coarctation anatomy managed successfully with a transcatheter approach, facilitated by meticulous planning using advanced imaging techniques. The first case had long-segment CoA, which required deployment of a custom-made 120-mm-long Cheatham platinum stent. The second case had coarctation associated with a hypoplastic arch and left subclavian ostial stenosis, which was managed with a combination of covered and uncovered stent. Both patients showed good postprocedural outcomes, which were confirmed by means of 3-month follow-up computed tomography demonstrating well expanded stents, no endoleak, complete exclusion of aneurysms, and well perfused great vessels.
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