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[PRIMARY STENT IMPLANTATION IN AORTIC COARCTATION. MID-TERM FOLLOW-UP]

Alcibar1, Peña, Oñate

  • 1Sección de Hemodinámica. Servicio de Cardiología. aSección de Cardiología Pediátrica. Hospital de Cruces. Vizcaya.

Revista Espanola De Cardiologia
|August 25, 2000
PubMed
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Primary stenting with balloon-expandable stents effectively treats aortic coarctation and recoarctation in patients of all ages, improving outcomes and reducing complications. This approach is particularly beneficial for complex cases and those with higher surgical risks.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Balloon-expandable stents offer an alternative therapy for stenotic lesions in congenital heart disease.
  • Stent implantation improves outcomes and reduces complications associated with balloon angioplasty for aortic coarctation and recoarctation.

Purpose of the Study:

  • To report the outcomes of primary stent implantation for coarctation and recoarctation of the aorta.
  • To evaluate the efficacy and safety of balloon-expandable stents in treating aortic coarctation.

Main Methods:

  • Balloon-expandable stents (Palmaz) were implanted in 14 patients (mean age 20 +/- 12 years) with native or postoperative coarctation.
  • A special technique was employed for 2 patients with complete aortic obstruction.

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  • The balloon-to-descending aorta diameter ratio was maintained at 1.
  • Main Results:

    • The procedure was effective in all 14 cases, significantly increasing coarctation diameter and decreasing transcoarctation systolic pressure gradient.
    • Clinical improvement was sustained at a mean follow-up of 19 +/- 8 months.
    • Angiographic follow-up at 1 year showed no recoarctation or restenosis in 7 patients.

    Conclusions:

    • Percutaneous endovascular stent implantation is an effective treatment for aortic coarctation and recoarctation in older children, adolescents, and adults.
    • Stenting is particularly advantageous for patients with complex anatomy and high surgical risk.
    • Primary stenting is anticipated to yield a lower complication rate compared to other methods.