Endovascular management of coarctation of the aorta in adult patients

BackgroundCoarctation is a congenital heart defect with an incidence of 5–8%, more frequent in boys; however, the overwhelming majority of patients undergo surgery earlier as pediatric patients. Currently, the treatment of choice in adolescents and adults is endovascular management.MethodWe used all three common catheter-based techniques: simple balloon dilatation, stent placement, and stent-graft placement. All treated patients underwent pre- and post-procedural CT angiography.Group of patientsBetween 2004 and 2014, we treated a total of 10 patients with coarctation. They included seven men and three women, with a mean age of 41.1 (21–59) years. Eight patients were treated for native coarctation, and two for re-coarctation. Dominant features included hypertension (eight patients) and left-sided heart failure (four patients); some patients presented with multiple conditions at a time. Simple dilatation was performed in two patients while four had both stent and stent-graft placement.ResultsAll procedures were technically successful, with a long-term beneficial effect seen in all patients. All patients with hypertension showed improvement, with medication either reduced or completely discontinued in four cases.