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Aim: To assess the acute results of the first human use of the Optimus covered stent in complex coarctation of the aorta., Methods and Results: We successfully implanted the Optimus covered stent in eight cases in patients whose preprocedural anatomy looked challenging for currently available covered stents. Six of the patients had native coarctation with one recoarctation following surgical repair. There were no significant complications with reduction in the mean invasive gradient from 22 to 1 mm Hg. The length of stents used ranged from 33 to 57 mm with a median shortening after expansion of 13%. Postprocedural follow-up with magnetic resonance imaging or computed tomography has not shown evidence of fracture or migration or renarrowing. The median duration of follow-up is 10 months., Conclusions: Preliminary results show that the Optimus covered stent is safe and efficacious for use in patients with coarctation of challenging morphology. A systemic trial will be required to evaluate this stent for more widespread practice., (© 2018 Wiley Periodicals, Inc.)

Coarctation of the aorta and interrupted aortic arch are not usually associated with stenosis of the innominate, common carotid, or subclavian arteries. We report two patients with stenoses of combinations of these arteries, one in association with coarctation (stented later in life) and the other in association with interrupted arch (arterial stenoses surgically repaired at the time of surgery for the arch proper). Both have done well.

The article discusses the medical case of a 16-year-old woman who sustained hypertension during her pregnancy. Base on the clinical examinations conducted, hypertension was caused by coarctation of the aorta, which is an unusual cause, hence, the commonest cause of hypertension in pregnancy is preeclampsia. The maternal mortality rate of coarctation is 3-8%, but in the case of the patient, the risk of fetal and maternal morbidity and mortality is high, due to severe pregnancy-induced hypertension in the 3rd trimester and the tight coarctation.