Background: Covered stents has decreased the risk of complications in coarctation of the aorta (CoA) and are now being used as primary treatment in selected patients.
Objective: To evaluate the use of covered Cheatham-Platinum (CP) stents in the management of native CoA.

Patients & Methods: 35 covered CP stents were implanted in 31 pts with native CoA from Jan 02-Dec 08. This represents 66% of all patients having coarctation stenting (>85% in last 2 years). Indications were severe and near atretic lesion, long segment CoA, transverse arch coarctation, Turner syndrome, associated PDA and rescue treatment in aortic dissection. This patient with bare stent related dissection had 4 covered stents in total.

Results: Mean age and weight were 24 (±13.7) years and 56 (±13) kg. The procedure was successful in 30/31 pts. One pt with complete interruption needed surgery. The systolic gradient across the CoA decreased from 52 (±28) mmHg to 5 (±3.5) mmHg (p<0.0001) & diameter of the CoA increased from 5.2 (±1.9) mm to 18 (±4.5) mm (p<0.0001). There was one death 3 days post procedure due to intracranial hemorrhage. Follow up period was up to 82 (mean 34) months. All stents were patent and in good position on CT performed 3-6 months later. In 33% of pts antihypertensive medication was either decreased or stopped.

Conclusion: Covered stents may be used safely and effectively as therapy of choice in adolescents/adults with severe and complex CoA. They are argued as preferred form of treatment for all adolescents and adults.