Surgical and endovascular treatment methods for aortic coarctation in patients of different age groups (literature review)
https://doi.org/10.29001/2073-8552-2026-41-3-53-63
Abstract
Introduction. Coarctation of the aorta (CoA) remains one of the most common congenital heart defects, associated with a high incidence of cardiovascular complications even after successful correction. Despite advances in both endovascular and surgical repair techniques, there is no unified approach to selecting the optimal treatment strategy, and the available data on long-term postoperative outcomes require systematic synthesis.
Aim: To analyze current data on the surgical and endovascular treatment of CoA in patients of different age groups, to characterize the anatomical features of the congenital defect, the technical aspects of interventions, immediate and long-term treatment outcomes, as well as to assess the incidence of complications and reinterventions.
Material and Methods. A literature search was performed using the electronic databases eLibrary.ru and PubMed. The study included articles published between 2014 and 2026. A total of 1,331 publications on aortic coarctation were screened. Ultimately, 52 studies were included in the final review.
Results. Analysis of the included publications showed that surgical correction remains the “gold standard” in neonates and young children, whereas endovascular repair is preferred in adolescents and adults. In the long term, neither of these strategies completely eliminates risks: the potential for arterial hypertension, recoarctation, aneurysm formation, and the need for repeat interventions persists.
Conclusion. The choice of treatment strategy for aortic coarctation should be individualized, taking into account the patient's age, the anatomy of the narrowing, and the technical capabilities of the medical center. However, all patients, regardless of the correction method, require lifelong dynamic follow-up with regular blood pressure monitoring and aortic imaging for timely detection and management of long-term postoperative complications.
Keywords
About the Authors
S. A. MagbulovaRussian Federation
Saihuna A. Magbulova - Graduate Student, Scientific Research Department, Meshalkin National Medical Research Center.
15, Rechkunovskaya str., Novosibirsk, 630055
K. A. Rzaeva
Russian Federation
Kseniya A. Rzaeva - Cand. Sci. (Med.), Endovascular Surgeon, Almazov National Medical Research Center.
2, Akkuratova str., Saint Petersburg, 197341
A. V. Voitov
Russian Federation
Aleksey V. Voitov - Cand. Sci. (Med.), Cardiovascular Surgeon, Research Scientist, Meshalkin National Medical Research Center.
15, Rechkunovskaya str., Novosibirsk, 630055
E. N. Amansakhatova
Russian Federation
Ekaterina N. Amansakhatova - Research Intern, Scientific Research Department, Meshalkin National Medical Research Center.
15, Rechkunovskaya str., Novosibirsk, 630055
I. A. Soynov
Russian Federation
Ilya A. Soynov - Dr. Med. Sci., Cardiovascular Surgeon, Head of the Scientific Research Department, Meshalkin National Medical Research Center.
15, Rechkunovskaya str., Novosibirsk, 630055
References
1. Soynov I.A., Gorbatykh Yu.N., Rzaeva K.A., et al. Results of correction of coarctation with hypoplasia of the aortic arch: “ascending sliding” against plasty of the aortic arch with a patch from the pulmonary homograph. Siberian Journal of Clinical and Experimental Medicine. 2024;39(2):122–132. (In Russ.) DOI: 10.29001/2073-8552-2022-625 EDN: TYXXUL
2. Soynov I.A., Kim A.I., Movsesyan R.R., et al. Surgical Management of congenital heart diseases in the Russian Federation: national registry data for 2024. Circulation Pathology and Cardiac Surgery. 2026;30(1):5–25. (In Russ.) DOI: 10.21688/1681-3472-2026-1-5-25 EDN: VOGWDG
3. Raza S., Aggarwal S., Jenkins P., et al. Coarctation of the Aorta: Diagnosis and Management. Diagnostics (Basel). 2023;13(13):2189. DOI: 10.3390/diagnostics13132189
4. Egunov O.A., Krivoshchekov E.V., Cetta F., et al. Surgery for aortic recoarctation in children less than 10 years old: A single-center experience in Siberia, Russia. J. Card. Surg. 2022;37(6):1627–1632. DOI: 10.1111/jocs.16435
5. Krivoschekov E.V., Egunov O.A., Podoksenov A.Yu., et al. Assessment of the immediate results of aortic coarctation surgical correction under conditions of antegrade selective cerebral perfusion. Pediatria. 2019;98(5):188–195. DOI: 10.24110/0031-403X-2019-98-5-188-195 EDN: ETRGGV
6. Stiller B., Zartner P., Dähnert I., et al. Prospective multicenter study of the breakable babystent for treatment of aortic coarctation in newborns and infants. Cath. Cardiovasc. Interv. 2022;99(5):1529–1537. DOI: 10.1002/ccd.30133
7. Agasthi P., Pujari S.H., Tseng A., et al. Management of adults with coarctation of aorta. World J. Cardiol. 2020;12(5):167–191. DOI: 10.4330/wjc.v12.i5.167
8. Bhatt A.B., Lantin-Hermoso M.R., Daniels C.J., et al. Isolated Coarctation of the Aorta: Current Concepts and Perspectives. Front. Cardiovasc. Med. 2022;9:817–866. DOI: 10.3389/fcvm.2022.817-866
9. Ellesøe S.G., Workman C.T., Bouvagnet P., et al. Familial co-occurrence of congenital heart defects follows distinct patterns. Eur. Heart J. 2018;39(12):1015–1022. DOI: 10.1093/eurheartj/ehx314
10. Parker L.E., Landstrom A.P. Genetic etiology of left-sided obstructive heart lesions: a story in development. J. Am. Heart Assoc. 2021;10(2):019006. DOI: 10.1161/j.jaha.120.019006
11. Doshi A.R., Chikkabyrappa S. Coarctation of Aorta in Children. Cureus. 2018;10(12):3690. DOI: 10.7759/j.cur.3690
12. Velukhanov I.A., Amansakhatova E.N., Bondarenko I.V., et al. Ten years of experience with total perfusion for cerebral and end-organ protection during aortic arch reconstruction in neonates. Circulation Pathology and Cardiac Surgery. 2026;30(1):90–98. (In Russ.) DOI: 10.21688/1681-3472-2026-1-90-98
13. Alkashkari W., Albugami S., Hijazi Z.M. Management of Coarctation of the Aorta in Adult Patients: State of The Art. J. Korean Circ. 2019;49(4):298–313. DOI: 10.4070/kcj.2018.0433
14. Rumyantseva A.A., Tarasov R.S., Khalivopulo I.K., Shushpannikov P.A., Grishacheva E.O. Stenting of critical aortic coarctation in newborn: a case series. Circulation Pathology and Cardiac Surgery. 2025;29(1):99–109. (In Russ.) DOI: 10.21688/1681-3472-2025-1-99-109 EDN: RUSPMT
15. Soynov I.A., Kornilov I.A., Gorbatykh A.V., et al. Long-Term Surgical Outcomes for Coarctation of the Aorta: A 15-Year Single-Center Experience. World J. Pediatr. Congenit. Heart Surg. 2026;17(4):509–517. DOI: 10.1177/21501351251396528
16. Mantri S.S., Raju B., Jumah F., et al. Aortic arch anomalies, embryology and their relevance in neuro-interventional surgery and stroke: A review. Interv. Neuroradiol. 2022;28(4):489–498. DOI: 10.1177/15910199211039924
17. Salciccioli K.B., Zachariah J.P. Coarctation of the Aorta: Modern Paradigms Across the Lifespan. Hypertension. 2023;80(10):1970–1979. DOI: 10.1161/Hypertensionaha.123.19454
18. Yu X., Xia L., Jiang Q., et al. Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses. J. Stroke. 2020;22(1):76–86. DOI: 10.5853/jos.2019.01312
19. Crafoord C., Nylin G. Congenital coarctation of the aorta and its surgical treatment. J. Thorac. Surg. 1945;14:347. DOI: 10.1016/S0096-5588(20)31801-8
20. Kumar T.K., Zurakowski D., Sharma R., et al.. Prediction of recurrent coarctation by early postoperative blood pressure gradient. J. Thorac. Cardiovasc.Surg. 2011;142(5):1130-6,1136.e1. DOI: 10.1016/j.jtcvs.2011.02.048
21. Pandey R., Jackson M., Ajab S., et al. Subclavian flap repair: review of 399 patients at median follow-up of fourteen years. Ann Thorac. Surg. 2006;81(4):1420–1428. DOI: 10.1016/j.athoracsur.2005.08.070
22. Sandoval J.P., Kang S.L., Lee K.J., et al. Balloon Angioplasty for Native Aortic Coarctation in 3- to 12-Month-Old Infants. Circ. Cardiovasc. Interv. 2020;13(11):008938. DOI: 10.1161/j.cin.120.008938
23. Vasile C.M., Laforest G., Bulescu C., et al. From Crafoord's End-to-End Anastomosis Approach to Percutaneous Interventions: Coarctation of the Aorta Management Strategies and Reinterventions. J. Clin. Med. 2023;12(23):7350. DOI: 10.3390/jcm12237350
24. Walhout R.J., Lekkerkerker J.C., Oron G.H., et al. Comparison of polytetrafluoroethylene patch aortoplasty and end-to-end anastomosis for coarctation of the aorta. J. Thorac. Cardiovasc. Surg. 2003;126(2):521-528. DOI: 10.1016/s0022-5223(03)00030-8
25. Gross R.E. Treatment of certain aortic coarctations by homologous grafts; a report of nineteen cases. Ann. Surg. 1951;134(4):753–768. DOI: 10.1097/00000658-195110000-00020
26. Yousif A., Kloppenburg G., Morshuis W.J., Heijmen R. Repair of adult aortic coarctation by resection and interposition grafting. Interact. Cardiovasc. Thorac. Surg. 2016;23(4):526–530. DOI: 10.1093/icvts/ivw206
27. Amato J.J., Rheinlander H.F., Cleveland R.J. A method of enlarging the distal transverse arch in infants with hypoplasia and coarctation of the aorta. Ann. Thorac. Surg. 1977;23(3):261–263. DOI: 10.1016/s0003-4975(10)64121-5
28. Soynov I.A., Rzayeva K.A., Gorbatykh Y.N., et al. Comparison of Sternotomy Access Versus Thoracotomy Access in the Surgical Treatment of Aortic Coarctation: A Propensity Score-matched Study. J. Saudi Heart Assoc. 2024;36(3):305–315. DOI: 10.37616/2212-5043.1396
29. Gray W.H., Wells W.J., Starnes V.A., Kumar S.R. Arch Augmentation via Median Sternotomy for Coarctation of Aorta With Proximal Arch Hypoplasia. Ann Thorac. Surg. 2018;106(4):1214–1219. DOI: 10.37616/2212-5043.1396
30. Meliota G., Lombardi M., Zaza P., et al. Balloon angioplasty of aortic coarctation in critically ill newborns using axillary artery access. Ann. Pediatr. Cardiol. 2020;13(1):67–71. DOI: 10.4103/apc.APC219
31. Singer M.I., Rowen M., Dorsey T.J. Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn. Am. Heart J. 1982;103(1):131–132. DOI: 10.1016/0002-8703(82)90539-7
32. Hartman E.M., Groenendijk I.M., Heuvelman H.M., et al. The effectiveness of stenting of coarctation of the aorta: a systematic review. EuroIntervention. 2015;11(6):660–668. DOI: 10.4244/EIJV11I6A133
33. Isselbacher E.M., Preventza O., Hamilton Black J., et al. Peer Review Committee Members. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J. Cir. 2022;146(24):e334–e482. DOI: 10.1161/j.cir.0000000000001106
34. Garg G., Goyal N., Mandhan G., Sidana P. Transfemoral balloon angioplasty of severe coarctation of aorta in 1200 g newborn. Ann Pediatr. Cardiol. 2017;10(1):95–96. DOI: 10.4103/0974-2069.197047
35. Rao P.S. Balloon Dilatation in the Management of Congenital Obstructive Lesions of the Heart: Review of Author's Experiences and Observations-Part II. J. Cardiovasc. Dev. Dis. 2023;10(7):288. DOI:10.3390/j.cdd10070288
36. Früh S., Knirsch W., Dodge-Khatami A., et al. Comparison of surgical and interventional therapy of native and recurrent aortic coarctation regarding different age groups during childhood. Eur. J. Cardioth. Surg. 2011;39(6):898–904. DOI: 10.1016/j.ejcts.2010.09.048
37. Harris K.C., Du W., Cowley C.G., et al. Congenital Cardiac Intervention Study Consortium (CCISC). A prospective observational multicenter study of balloon angioplasty for the treatment of native and recurrent coarctation of the aorta. Cath. Cardiovasc. Interv. 2014;83(7):1116– 1123. DOI: 10.1002/ccd.25284
38. Sinelnikov Y.S., Kornilov I.A., Soynov I.A. Pseudoaneurysm and aorto-bronchial fistula following balloon dilation of recoarctation. Cardiol. Young. 2016 26(3):596–598. DOI: 10.1017/S1047951115001584
39. Yang L., Chua X., Rajgor D.D., et al. A systematic review and meta-analysis of outcomes of transcatheter stent implantation for the primary treatment of native coarctation. J. Int. Cardiol. 2016;223:1025–1034. DOI: 10.1016/j.ijcard.2016.08.295
40. Stegeman R., Breur J.M.P.J., Heuser J., et al. Primary coronary stent implantation is a feasible bridging therapy to surgery in very low birth weight infants with critical aortic coarctation. Int. J. Cardiol. 2018;261:62–65. DOI: 10.1016/j.ijcard.2018.03.009
41. Rzaeva K.A., Soynov I.A., Gorbatykh A.V., et al. Palliative stenting of aortic coarctation in critically ill newborns. J. of Thorac. and Cardiovas. Surgery. 2023;65(3):277–285. (In Russ.). DOI: 10.24022/0236-2791-2023-65-3-277-285 EDN: RPHUCZ
42. Taggart N.W., Minahan M., Cabalka A.K., et al. COAST II Investigators. Immediate Outcomes of Covered Stent Placement for Treatment or Prevention of Aortic Wall Injury Associated With Coarctation of the Aorta (COAST II). J. JACC Cardiovasc. Interv. 2016;9(5):484–493. DOI: 10.1016/j.jcin.2015.11.038
43. Holzer R.J., Gauvreau K., McEnaney K., et al. Long-Term Outcomes of the Coarctation of the Aorta Stent Trials. Circ. Cardiovasc. Interv. 2021;14(6):e010308. DOI: 10.1161/j.cin.120.010308
44. Cabrelle G. A case of AndraStent fracture in a patient with aortic coarctation: a review of the literature. Cardiol. Young. 2020;30(7):1035– 1038. DOI: 10.1017/S1047951120001304
45. Sohrabi B., Jamshidi P., Yaghoubi A., et al. Comparison between covered and bare Cheatham-Platinum stents for endovascular treatment of patients with native post-ductal aortic coarctation: immediate and intermediate-term results. JACC Cardiovasc. Interv. 2014;7(4):416–423. DOI: 10.1016/j.jcin.2013.11.018
46. Sallmon H., Berger F., Cho M.Y., Opgen-Rhein B. First use and limitations of Magmaris® bioresorbable stenting in a low birth weight infant with native aortic coarctation. Cath. Cardiovasc. Interv. 2019;93(7):1340– 1343. DOI: 10.1002/ccd.28300
47. Schranz D., Zartner P., Michel-Behnke I., Akintürk H. Bioabsorbable metal stents for percutaneous treatment of critical recoarctation of the aorta in a newborn. Cath. Cardiovasc. Interv. 2006;67(5):671–673. DOI: 10.1002/ccd.20756
48. Dehaki M.G., Ghavidel A.A., Givtaj N., et al. Recurrence rate of different techniques for repair of coarctation of aorta: A 10 years’ experience. Ann Pediatr. Cardiol. 2010;3(2):123–126. DOI: 10.4103/0974-2069.74038
49. Mohan U.R., Danon S., Levi D., et al. Stent implantation for coarctation of the aorta in children <30 kg. JACC Cardiovasc. Interv. 2009;2(9):877– 883. DOI: 10.1016/j.jcin.2009.07.002
50. Sen S., Garg S., Rao S.G., Kulkarni S. Native aortic coarctation in neonates and infants: Immediate and midterm outcomes with balloon angioplasty and surgery. Ann Pediatr. Cardiol. 2018;11(3):261–266. DOI: 10.4103/apc.APC_165_17
51. Forbes T.J., Garekar S., Amin Z., et al, Congenital Cardiovascular Interventional Study Consortium (CCISC). Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: a multi-institutional study. J. Cath. Cardiovasc. Interv. 2007;70(2):276–285. DOI: 10.1002/ccd.21164
52. Forbes T.J., Kim D.W., Du W., et al. CCISC Investigators. Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta: an observational study by the CCISC (Congenital Cardiovascular Interventional Study Consortium). J. Am. Coll. Cardiol. 2011;58(25):2664–2674. DOI: 10.1016/j.jacc.2011.08.053
Review
For citations:
Magbulova S.A., Rzaeva K.A., Voitov A.V., Amansakhatova E.N., Soynov I.A. Surgical and endovascular treatment methods for aortic coarctation in patients of different age groups (literature review). Siberian Journal of Clinical and Experimental Medicine. 2026;41(3):53-63. (In Russ.) https://doi.org/10.29001/2073-8552-2026-41-3-53-63
JATS XML

.png)
.png)
























