Purpose
To describe the immediate results of percutaneous management of both native aortic coarctation
(NaCoA) and recoarctation of the aorta (ReCoA) at the Lausanne University Hospital.
Methods
We searched our catheterization database to identify all patients with either NaCoA or ReCoA who
underwent percutaneous dilatation by either balloon angioplasty (BAP) or endovascular stent
implantation (ESI) between January 2011 and December 2017. Successful dilatation was defined as a
residual peak-to-peak gradient (PPG) <20 mmHg or a ≥50% reduction in the gradient if the preintervention
PPG was <20 mmHg.
Results
63 patients (mean age 8.8 ± 9.4 years) were identified. Out of 11 patients with NaCoA, 7 underwent
BAP and 4 had ESI, and out of 52 patients with ReCoA, 42 underwent BAP and 10 had ESI. In patients
with NaCoA, BAP had a success rate of 57% with the mean PPG decreasing from 35.4 ± 22.3 mmHg to
16.4 ± 9.0 mmHg (p<0.05), and ESI had a success rate of 100%, with the mean PPG decreasing from 28
± 20.5 mmHg to 3.5 ± 3.9 mmHg (p=0.11). In patients with ReCoA, BAP had a success rate of 69% with
the mean PPG decreasing from 24 ± 15.8 mmHg to 10.1 ± 10.0 mmHg (p<0.005), and ESI had a success
rate of 100%, with the mean PPG decreasing from 18.3 ± 11.2 mmHg to 2.4 ± 4.8 mmHg (p<0.05). ESI
was more successful when compared to BAP (p<0.05). There was only one complication, a very small
aortic aneurysm in a patient with NaCoA who underwent BAP.
Conclusion
Percutaneous management of coarctation of the aorta is safe and effective in both NaCoA and ReCoA.
Stent implantation is more effective than BAP.