Transcatheter Approach to Coarctation of Aorta and Isolated Interrupted Aortic Arch in Adults

Isolated coarctation of the aorta (COA) is a localized aortic narrowing (usually post-ductal, near subclavian artery) that mainly remains undiagnosed in adulthood and is detected incidentally in a hypertensive patient with Radial-Femoral pulse delay. Untreated patients have poor prognoses. Previously, the gold standard of treatment was the surgical repair. However, during the last two decades, balloon angioplasty with stenting has perceived their roles and long-term outcome trials confirmed the safety and effectiveness of transcatheter (TC) coarctoplasty in adulthood. Interrupted aortic arch (IAA) is aortic luminal disruption between ascending and descending aorta, a complex congenital heart disease commonly associated with other congenital anomalies. Although, the surgical approach was the first option for those with associated other anomalies, in selected cases, percutaneous reconstruction of IAA before surgical repair of other defects, facilitates the surgeon’s point of view. In this section, we will discuss the role of cardiac imaging in diagnosing COA and IAA and their roles in characterizing the appropriate cases for the TC approach, the interventional tackle, and post-procedure follow-up.