ENDOVASCULAR TREATMENT OF NATIVE COARCTATION OF THE AORTA IN ADULTS: MOROCCAN EXPERIENCE

Coarctation of the aorta is a congenital heart disease characterized by a local narrowing of the aortic lumen, most often located at the level of the aortic isthmus.It is rarely diagnosed in adulthood, which in this case it is discovered through etiological assessment of arterial hypertension. Endovascular treatment has become an alternative therapy to surgery. Material and methods:Our work includes a retrospective serie of 5 cases of coarctation of the aorta (CoA) treated by endovascular approach, casesthat had been compiled in the vascular surgery department of Ibn Sina Hospital in Rabat, over a period of time between January 2010 and April 2015. The follow-up was based on the measurement of blood pressure and a radiological follow-up byComputed Tomography Angiography (CTA). Result:The mean age of the patients was 22 years old. Arterial hypertension with a pressure gradient between arm and leg was the usual clinical presentation. Clinical diagnosis was confirmed by CT-angiography. The coarctation of the aorta (CoA) was located at the thoracic level in 3 patients and at the abdominal level in 2 others. Two patients were treated by balloon angioplasty alone while the othersangioplasting + stenting: covered stents (stent grafts) in 2 patients, and a bare metal stent in 1 patient. The results during a long-term follow-up showed a normalization of blood pressure under low dose combination therapy in 4 patients, while in a single patientnutritional-hygienic measures. Also the radiological follow-up showed a decrease in the trans-stenotic pressure gradient and the absence of restenosis. Conclusion: CoA is a congenital malformation that is not uncommon, and diagnosis is clinical. The debate about therapeutic choice is open; however the endovascular approach remains the least invasive one.