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Cardiovascular changes after transcatheter endovascular stenting of adult aortic coarctation

Sonya V Babu-Narayan1, Raad H Mohiaddin1, Timothy M Cannell2

  • 1Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK.

International Journal of Cardiology
|February 2, 2010
PubMed

Insights

Transcatheter endovascular stenting effectively treated aortic coarctation in adults, improving blood pressure, cardiac function, and vascular health. This procedure offers a promising reduction in cardiovascular risk factors.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Limited long-term data exists for transcatheter endovascular stenting in adult aortic coarctation.
  • The study aimed to evaluate the effects of stenting on blood pressure, collateral circulation, left ventricular (LV) mass, and vascular function.

Purpose of the Study:

  • To assess the efficacy and clinical outcomes of transcatheter endovascular stenting in adults with aortic coarctation.
  • To investigate the impact of stenting on hemodynamic parameters and cardiac remodeling.

Main Methods:

  • Eighteen adult patients with aortic coarctation underwent endovascular stenting.
  • Clinical assessments and cardiovascular magnetic resonance imaging were performed before and after stenting (mean follow-up: 10.2 months).
  • The Fredriksen coarctation index was used to assess the severity of coarctation pre- and post-intervention.

Main Results:

  • Successful relief of coarctation was achieved in all patients, with a significant increase in the coarctation index.
  • Blood pressure decreased significantly post-stenting (p<0.001).
  • Left ventricular (LV) mass index decreased (p=0.003), LV ejection fraction increased (p=0.01), and ascending aorta distensibility improved (p=0.04).
  • Flow through collateral arteries decreased significantly (p<0.001).

Conclusions:

  • Transcatheter endovascular stenting is a safe and effective treatment for adult aortic coarctation.
  • The procedure leads to significant improvements in cardiac and vascular function.
  • Reduced LV mass suggests a potential for decreased long-term cardiovascular risk.
Abstract

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