Caveat Emptor

Coarctation of the aorta, a narrowing or occlusion of the aorta, occurs generally in the region of the ligamentum arteriosum and represents 5% to 8% of all congenital heart lesions. Although most often diagnosed in infancy, a small proportion present in adolescence or adulthood during evaluation for a heart murmur, reduced peripheral pulses, or therapy-resistant hypertension. It represents one of the first congenital lesions to be successfully addressed surgically1 and has a 7-decade long history as a therapeutic treatment. However, even after successful repair, survival is reduced when compared with the general population if repair takes place later life (>5 years of age).2 Repair is nonetheless advocated in the older patient to reduce the cardiovascular event risk and improve survival.3 Several surgical approaches have evolved during the years, with percutaneous treatment options only becoming available in the 1980s, first with balloon angioplasty and balloon expandable stent implantation in the late 1990s.4,5 Although clinical acceptance of percutaneous approaches was initially slow, improved techniques, operator experience, and balloon and stent technology have resulted in an enhanced clinical acceptance with improved safety profiles and success rates, although not without controversy.6 There remains a scarcity, however, of long-term follow-up studies after endovascular repair in regards to the development of aneurysm formation, recurrent obstruction, and general cardiovascular mortality and morbidity.See …