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Hypertension in patients with repaired aortic coarctation: the long and puzzling road from Morgagni to stent implantation
  1. Gianfranco Butera1,2
  1. 1 Pediatric Cardiology, Evelina London Children’s Hospital, London, UK
  2. 2 School of Biomedical Engineering & Imaging Sciences, Kings College, London
  1. Correspondence to Dr Gianfranco Butera, Pediatric Cardiology, Evelina London Children’s Hospital, London SE1 7EH, UK; gianfrancobutera{at}libero.it

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Aortic coarctation (CoAo) is a common congenital heart disease that may occur isolated or associated to complex malformations. Giovan Battista Morgagni first described it in the XVIII letter of his book De sedibus and causis morborum per anatomen indagatis published in Venice in 1761. This publication represented one of the first systematical efforts to use anatomopathology as a tool to understand and explain clinical manifestations. In fact, before Morgagni, a disease was considered as an imbalance of ‘humours’ and fluids.

Nowadays, following a mechanistic approach, treatment of CoAo aims to get rid of the stenotic segment.

Treatment depends on many factors including patient size and age, type of lesion and individual anatomy. In older children, adolescents and adults, a transcatheter approach is usually preferred to the surgical treatment. Percutaneous procedures include balloon angioplasty and stent implantation. Even if balloon angioplasty has been shown favourable results, it may be complicated by aortic wall injury and a higher rate of recurrence.1 Therefore, in suitable anatomy and patient size, stent placement has become the treatment of choice.

Nevertheless, …

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Footnotes

  • Contributors GB conceived and wrote the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Patient consent for publication Not required.

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