Modern possibilities of stenting aortic coarctation in adults: analysis of clinical observations

Background: Coarctation of the aorta occurs in newborns as a primary condition, and in most cases it is critical and associated with other congenital heart defects. Besides, coarctation of the aorta may be first detected in older children, adolescents, and adults; this pathology is diagnosed both as an isolated heart defect and in combination with other heart defects (congenital or acquired), or as a consequence of restenosis of a previously operated aorta. In the adults, coarctation of the aorta is often associated with severe comorbidities and decompensated conditions, such as decreased left ventricular myocardial contractility, congestive heart failure, and high pulmonary hypertension. The choice of surgical tactics in such patients remains controversial; although in case of native coarctation of the aorta, as well as in the case of recoarctation, if technically feasible, stenting is considered the preferred method of choice in many specialized centers. Objective: The study aimed to present clinical experience of involving endovascular methods for correction of coarctation of the aorta in adult patients using a series of four cases as an example. Methods: From 2021 to 2025, specialists of our clinical unit performed aortic coarctation stenting in four adult patients, aged 26 to 51 years, with comorbidities. In all cases, the chosen tactic was stenting of aortic coarctation by puncture access through the common femoral artery on the right under local anesthesia. Results: All patients had been under long-term monitoring for hypertension with no positive effect achieved due to high doses of antihypertensive medications. Further examinations revealed a congenital heart defect: coarctation of the aorta. Due to the severity of the condition in three cases and at the patient’s request in one case, all of them underwent stenting of the coarctation of the aorta. The postoperative period was without complications, and a positive effect was noted immediately after the procedure. In two cases, no recurrence of aortic restenosis was recorded during a three-year follow-up. Conclusion: Stenting of aortic coarctation in adult patients is currently the method of choice, offering high safety and efficacy, with advantages over open surgical interventions in terms of the degree of trauma and rehabilitation timeframe.