Stenting of hypoplastic aortic segments with mild pressure gradients and arterial hypertension

Objective: To determine the safety, feasibility and effectiveness of stent expansion of hypoplastic aortic segments with pressure gradients in patients with arterial hypertension. Design: Non-randomised prospective clinical trial. Setting: Tertiary referral centre, congenital cardiac unit. Patient selection: 20 consecutive patients (median age 14.5 years, range 11.6–38.8 years) with arterial hypertension and a hypoplastic segment of the aorta. Seventeen patients had successful previous arch interventions in a coarctation site. Interventions: Stent deployment in hypoplastic arch segments. Main outcome measures: Gradient across the aortic arch; complications early and during follow up; residual hypertension. Results: 23 stents were deployed: 13 in the cross and 10 in the isthmus. The mean gradient across the aortic arch decreased from 16 (SD 6) (median 17) to 3 (4) (median 1) mm Hg (p Conclusions: Pressure loss due to residual hypoplastic aortic segments can be treated effectively and safely with stent expansion. Some patients remain mildly hypertensive and require additional drug treatment.