Aortic stenting for aortic isthmus stenosis caused by the patent ductus arteriosus occluder: a case report

We present a case report of stenting the aortic isthmus to manage a rare complication – stenosis caused by the patent ductus arteriosus occlude previously implanted to a child at the age of 7 months. After 7 years the patient was re-admitted to the cardiology hospital with the signs and symptoms of the aortic coarctation. The echocardiography revealed a peak pressure gradient of 40 mm Hg in the area of the aortic isthmus. The pressure gradient between the upper and lower extremities was 25-30 mm Hg. At the age of 8 the compromised blood flow in the aorta was completely resolved by stenting the aortic isthmus with covering of the implanted occluder. Andrastent XL (Andramed GmbH, Reutlingen, Germany) stent was implanted. Characteristics of this stent allow expanding it up to 14 mm. The pressure gradient in the area of the aortic isthmus was completely eliminated after the procedure. The effectiveness of the intervention was confirmed after 7 months with echocardiography. In conclusion, the aortic stenting using devices with the potential for further expansion as the child grows is justified due to its effectiveness, minimal invasiveness, and radical nature.