Covered Stent Implantation in a Preemie with Aortic Coarctation and Huge Patent Ductus Arteriosus: A Single Solution for Two Lesions.

Severe aortic coarctation in premature infant is a very challenging clinical situation. Surgery is the standard treatment, however it carries high complications rate particularly in presence of other comorbidities. Percutaneous procedure with balloon angioplasty or stenting is a valid alternative with a good safety profile. Here we report the case of a premature male infant born at 33 weeks of gestational age with a birth weight of 1.65 kg, affected by a complex genetic syndrome and multiple malformations. Echocardiography showed a wide PDA (Patent Ductus Arteriosus) with bidirectional shunt and hypoplasia of the transverse arch with a severe isthmic coarctation. The patient underwent a technically successful percutaneous procedure performed using a coronary covered stent implanted across the aortic isthmus, simultaneously addressing the coarctation and achieving near-complete PDA closure. The procedure was completed without complications and resulted in immediate hemodynamic improvement, with normalization of the isthmic gradient. Post-procedural imaging confirmed adequate stent positioning and effective ductal closure.