Aim .– The aim of this study was to assess the results of transcatheter stent treatment of native or recurrent coarctation of the aorta in adolescents and adults, as an alternative to surgery.

Material and methods .– Single-center study included patients aged > 10 years with significant recurrent or native coarctation of the aorta. Clinical data (blood pressure, antihypertensive medications), echocardiographic (maximal aortic gradient, LV shortening fraction), CTscan (isthmus diameter) measurements and hemodynamical isthmus gradient were assessed before and after the procedure. All procedures were performed under general anesthesia.

Results .– From 2009 to 2012, eighteen patients, aged 10.8 to 49 years (mean 26), with native (6) or recurrent (12) coarctation underwent transcatheter stent placement. All had high blood pressure and 80% were given antihypertensive medications. Doppler peak systolic gradient across the coarcted segment before procedure was 61 ± 16 mmHg, LV hypertrophy was present in 50% of the cases, mean LVSF was 27%. Stent was successfully implanted in all patients. The balloon to coarcted segment diameter ratio was 2.5 ± 0.5, stents diameters ranged 34 to 45 mm. Peak to peak hemodynamic gradient decreased from 25 ± 11 before to 3 ± 3 mmHg after stent placement. Doppler maximal gradient decreased to 20 ± 5 mmHg. Arterial hypertension regressed or improved in 77% of the cases. Echocardiographic LV hypertrophy persisted in only 30% of the cases. These results maintained at mean 19-months follow-up (1 month to 3 years). Adverse events included one early femoral artery thrombosis and one external iliac artery thrombosis, but no clinical limb ischemia occurred.

Conclusion .– Percutaneous stent placement for management of native or recurrent aortic coarctation is an efficient and safe alternative to surgery, and is associated with a long term reduction in blood pressure and LV hypertrophy.