Coarctation of the aorta accounts for 4 – 8 % of all congenital heart diseases, with an incidence of approximately 4 cases per 10.000 births with a male predominance¹. Coarctation may be seen in isolation or with additional cardiac lesions, such as bicuspid aortic valve, ventricular septal defect, patent ductus arteriosus, transposition of the great arteries, atrioventricular canal defects, or left sided obstructive heart defects, including hypoplastic left heart syndrome³.

Coarctation of the Aorta (CoA) is defined as local narrowing of the aorta². This narrowing typically occurs in the proximal descending aorta, near the insertion of the patent ductus arteriosus, but can vary in the location and length of the lesion¹.

Management of patients with coarctation depends on the age at diagnosis and the overall severity of the lesion. Surgical repair remained the only form of intervention until the advent of balloon aortic angioplasty in the 1980s.

Percutaneous techniques have evolved since with continuous advancement in sheath, balloon, and stent technology, which have progressively allowed for the passage of larger diameter equipment through smaller diameter access sheaths¹.

In neonates, infants and young children, surgical resection of the CoA segment is the treatment of choice³.

Native coarctation of the aorta, especially in adolescents and adults, is treated with balloon-expandable stents as first-line therapy, like the AndraStent^® Aortic. Balloon-expandable stents with large diameters can be re-dilatated up to an adult size of the aorta¹.

To ensure a safe delivery of the AndraStent^®, we recommend to use our AndraBalloon^® or Andra2Balloon as Stent-Delivery Catheter.

Recurrent Coarctation or selected, milder forms of non-neonatal discrete coarctation can occasionally be treated successfully with balloon aortic angioplasty alone¹.

¹ Batlivala, S.P., Goldstein, B.H. Current Transcatheter Approaches for the Treatment of Aortic Coarctation in Children and Adults. Intervent Cardiol Clin, 8(1), 47-58 (2017). https://doi.org/10.1016/j.iccl.2018.08.001
² Dijkema, E.J., Slieker, M.G., Breur, J.M.P.J. et al. Preserved Myocardial Deformation after Successful Coarctation Repair: A CMR Feature-Tracking Study. Pediatr Cardiol 39, 555–564 (2018). https://doi.org/10.1007/s00246-017-1788-1
³ Torok, R.D., Campbell, M.J., Fleming, G.A., et al. Coarctation of the aorta: Management from infancy to adulthood. World J Cardiol 7(11): 765-775 (2015). http://dx.doi.org/10.4330/wjc.v7.i11.765