chapter  29
5 Pages

Complications of coarctation stenting in the adult patient

WithRoy P Venzon, Ziyad M Hijazi

Coarctation of the aorta is a congenital narrowing of the descending thoracic aorta distal to the origin of the left subclavian artery and in the region of the ductus arteriosus. It is a relatively common disorder and accounts for 7% of cases of all known congenital heart disease.1 The severity of the disease can vary from mild stenosis to complete interruption of the aorta (acquired atresia). Patients who present in adulthood are typically found to be hypertensive and have discrepant pulses between the upper and lower extremities. If left untreated, significant coarctation results in serious morbidity and has a mortality rate of 50% by the age of 32 years, and 92% by the age of 60 years.2

Because of this, therapy is generally recommended when a pressure gradient of at least 20 mmHg exists between the upper and lower extremities.3