Critical aortic coarctation in very low weight premature: primary angioplasty with coronary stent as bridging therapy. Case resolution

Abstract

Surgery was discarded due to the patient’s critical condition and low body weight. Emergency cardiac catheterization with stenting was attempted to reduce the risk of early re-coarctation. Ultrasound-guided percutaneous access was used via right carotid artery (4-Fr introducer sheath). The angiography performed confirmed the critical preductal aortic coarctation and the ductus arteriosus (figure 1, video 1 of the supplementary data) with a 3.2 mm underdeveloped transverse arch and a 4.5 mm distal and diaphragmatic aorta. A 4 mm × 16 mm coronary stent was implanted, the distal transverse arch was slightly oversized, and the left subclavian artery was crossed resulting in the uneventful angiographic resolution of the coarctation (figure 2, video 2 of the supplementary data). Gradients were not measured due to the patient’s unstable condition.