The gradient across coarctation is not simply (& solely ) determined by degree of obstruction , as one would believe.Understanding the hemodynamics and various factors that can influence the gradient is essential Relieving the obstruction /gradient by stent or surgery may not be synonymous with successful treatment as we understand now the entire aorta right from the root to abdomen can influence the gradient ,along with systemic factors.We also know , some of these patients harbor histological abnormalities in the entire stretch of Aorta , what is being referred to as pan aortopathy , that may influence the long-term outcome.
Dr.S.Venkatesan MD 