title: Coarctation of the aorta: nonsurgical treatment using stent implantation.
abstract: BACKGROUND
  Coarctation of the aorta (CoA) accounts for 5%-8% of all congenital heart defects. If left untreated, most patients with significant CoA will have varying degrees of morbidity (e.g. hypertension, stroke, collateral formation and ventricular hypertrophy), possibly even mortality. Traditionally, treatment for this condition is surgical. Herein, we report stenting during catheterisation as an alternative nonsurgical treatment option for patients with CoA, and present the treatment outcomes of patients who underwent this treatment option.
  
  
  METHODS
  We retrospectively reviewed four patients (2 men and 2 women; age range 20-41 years) who underwent CoA stenting under general anaesthesia for the treatment of native CoA or restenosis of CoA at our institution. Three patients had a 40-mm Palmaz stent inserted, while one had a 39-mm Cheatham-Platinum covered stent inserted. Angiography and measurement of pressure gradients were performed before and after stent implantation to ensure good treatment outcomes.
  
  
  RESULTS
  The patients' treatment outcomes were good, with a significant reduction in pressure gradients across the narrowed segments. Angiography showed relief of CoA. The patients were followed up for 1-3 years, during which no complications were noted.
  
  
  CONCLUSIONS
  This is the first reported series in Singapore on the nonsurgical treatment of CoAs in adult patients using stents during interventional cardiac catheterisation. This less invasive procedure may lead to a new paradigm shift with regard to the treatment of CoA.
authors.forename: H L
authors.initials: HL
authors.lastname: Ang
authors.forename: C W
authors.initials: CW
authors.lastname: Lim
authors.forename: C
authors.initials: C
authors.lastname: Hia
authors.forename: J
authors.initials: J
authors.lastname: Yip
authors.affiliation: Division of Cardiology, Department of Paediatrics, National University of Singapore, Lower Kent Ridge Road, Singapore. swee _chye _quek@nuhs.edu.sg.
authors.forename: S C
authors.initials: SC
authors.lastname: Quek
mesh_terms: D000328:Adult; D000792:Angiography; D001017:Aortic Coarctation / Q000628:therapy*; D006328:Cardiac Catheterization; D005260:Female; D006801:Humans; D008297:Male; D011312:Pressure; D012189:Retrospective Studies; D012846:Singapore; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult