Balloon Dilation and Stent Placement for Coarctation

Since its initial description in the early 1980s, balloon dilation (with or without stenting) as a treatment for coarctation of the aorta has become increasingly common, particularly outside of the neonatal period. Catheter intervention is generally recognized as the preferred method of treating recurrent coarctation. For native coarcation most centers will consider treatment of the older child or adult with primary catheter therapy, whereas balloon dilation of native coarctation in infancy is rare. Obviously, there are many diverse situations in which arch obstruction can occur, ranging from isolated coarctation with an otherwise normal heart to complex postsurgical arch obstruction following single ventricle palliation. The approach to each patient will be individualized, but there are common elements to these cases which are outlined below.