Evaluation of exercise-induced hypertension post endovascular stenting of coarctation of aorta

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Hojat Mortazaeian1, Mohammad Yoosef Aarabi Moghadam, Mehdi Ghaderian

  • 1Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

The Journal of Tehran Heart Center
|October 18, 2012
PubMed

Insights

Endovascular stenting effectively reduces blood pressure gradients in patients with coarctation of the aorta (COA). This treatment normalizes systemic blood pressure at rest and during exercise, offering an alternative to surgery.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Coarctation of the aorta (COA) is a congenital heart defect affecting 5-8% of patients.
  • Balloon angioplasty is a common treatment, with endovascular stenting explored to enhance efficacy and safety.
  • Evaluating stenting's impact on blood pressure gradients is crucial for managing COA.

Purpose of the Study:

  • To assess systolic blood pressure gradients at rest and during maximal exercise post-endovascular stenting in COA patients.
  • To compare pre-stenting and follow-up pressure gradients.
  • To determine the effectiveness of stenting in alleviating aortic arch obstruction.

Main Methods:

  • Thirteen patients (4 native COA, 9 re-coarctation) underwent endovascular stenting.
  • Mean age was 11.1 ± 4.7 years; procedures occurred between Nov 2007 and Dec 2009.
  • Doppler echocardiography and resting/exercise blood pressure assessments were performed pre- and post-stenting.

Main Results:

  • No major angiographic complications were observed post-stent implantation.
  • Systolic blood pressure gradient significantly decreased from 42 ± 8.8 mm Hg to 7 ± 10 mm Hg (p < 0.001).
  • Peak Doppler pressure gradient reduced from 30 ± 14 mm Hg to 14 ± 10 mm Hg (p < 0.007); one case of exercise-induced hypertension occurred.

Conclusions:

  • Endovascular stenting is a viable alternative to surgery for native COA and residual/re-coarctation.
  • Stenting effectively alleviates aortic arch obstruction in the early follow-up period.
  • Systemic blood pressure normalizes at rest and during maximal exercise post-stenting.
Abstract

Keywords:
Aortic coarctationHeart defects, congenitalHypertensionStents

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