Cardiology

Hypertension in patients with repaired aortic coarctation: the long and puzzling road from Morgagni to stent implantation

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…

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