Discomfort after stenting for aortic coarctation

  Some patients with aortic coarctation require implantation of a large overlapping stent, which is a simple and safe procedure and is the main tool for DeBakey type III coarctation. However, most patients have some discomfort after the procedure, such as back pain and fever. Recently, after total aortic arch replacement and intraoperative large stent implantation in descending aorta for a DeBakey type I patient, we performed another large stent distal to the overlapping stent implantation, and the operation went very well, and another overlapping stent was implanted inside the original stent to seal the breach of the original stent distal to the stent. However, after the operation, the patient developed severe symptoms, including chest tightness, cough, and poor diet, which seriously affected normal life.  Why did these symptoms occur after stent implantation?  First of all, the stent itself is a foreign body, and the body will always have some reactions, manifesting as fever, weakness, etc. Secondly, since the aorta is thicker after stent implantation, the aortic wall is stretched and causes pain. Thirdly, the thickening of the aorta will compress the surrounding organs, such as trachea, esophagus and lung lobe, causing chest tightness, shortness of breath, cough and even obstruction of diet.  How to solve the above problems?  Most of the problems can be relieved quickly as the body adapts, such as fever, weakness, pain, etc. Some compression symptoms may last longer and can be relieved by rest, increased nutrition, and appropriate oral medications that mediate the nerves, such as Dextran.