Percutaneous dilation of aortic coarctation: Short and mid term results

Introduction Percutaneous angioplasty, has become the elective treatment for coarctation of the aorta(CoA) in adulthood. However, many complications can occur in the short,and long term like Htn,recoarctation(reCoA)and aneurysm formation. Methods This was a retrospective, mono-centric and descriptive study of patients with CoA in whom percutaneous dilation was performed. Patients were collected from our Cardiology department over a period from2013 to2019. Results Twenty three percutaneous dilations of CoA were performed. The average age of percutaneous treatment was 30 years (6 to 51 years).There was a female predominance(12 girls).The most common circumstance of dicovery of CoA was Htn (17 cases).which was unbalanced under treatment in14 patients. The site of CoA was isthmic in 20 cases. Aortic valve was bicuspid in 5 cases. Grade II aortic insufficiency was noted in5 cases. Percutaneous dilation was performed on native CoA in 15 cases and on reCoA in 8 cases. Dilation was performed by a balloon alone in 11cases (including all reCoA).9 patients underwent balloon dilation and stent placement. The size of the balloon used was on average 12 × 30 mm. The average size of stent was14 × 36 mm. Gradient between ascending and descending aorta averaged increased from 48 mmhg (15 to 90 mmhg) before dilation to 10 mmhg (0 to 25 mmhg)after dilation. The result was satisfactory with fingerprinting taken in 21 cases. No immediate complications were noted in all cases. Regular monitoring of BP (self-measurement) has shown that BP has balanced in 13 patients after 1month.ReCoA occurred in 10 patients after an average of 3 years indicating percutaneous re-dilation in 7 cases and surgical treatment in the other cases. 2 patients developed an aortic aneurysm at the exit of the stent at 4 years of follow-up. Conclusion CoA is not a simple narrowing of the aortic isthmus, but rather an arterial disease. In adults, the treatment of coarctations and localized recoarctations essentially involves percutaneous dilation