Transcatheter relief of coarctation of the aorta in a persistent fifth aortic arch anatomy

Abstract We present a case of persistent fifth aortic arch with coarctation diagnosed in a 5 year old child, initially managed by percutaneous balloon angioplasty ultimately undergoing percutaneous stenting of the coarctation of the aorta. The coarctation was initially treated with balloon angioplasty, but a moderate recoarctation occurred recurred. The child remained asymptomatic with normal left ventricular function. She was followed longitudinally until large enough to undergo stent placement and at 7 years of age with a weight of 31 kg underwent stenting. The procedure was tolerated well with significant improvement in peak gradients. Over the two-year follow-up period, the child has not required further intervention. Transcatheter relief of an aortic arch obstruction in the setting of a persistent fifth aortic arch anatomy is feasible and can provide a durable option even in young children.