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Stent Repair for Complex Coarctation of Aorta

José Suárez de Lezo1, Miguel Romero1, Manuel Pan1

  • 1Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.

JACC. Cardiovascular Interventions
|August 29, 2015
PubMed

Insights

Stent repair is a safe and feasible treatment for complex coarctation of the aorta, even with challenging conditions like aortic arch interruption or aneurysms. Long-term follow-up shows sustained positive outcomes and high survival rates.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Coarctation of the aorta (CoA) is a congenital heart defect requiring intervention.
  • Stent repair offers a percutaneous alternative to surgical correction for CoA.
  • Complex anatomical variations can present challenges in CoA treatment.

Purpose of the Study:

  • To evaluate the feasibility and safety of stent repair for complex coarctation of the aorta.
  • To identify challenging anatomic or evolving characteristics that may complicate treatment.
  • To assess long-term outcomes of percutaneous treatment in complex CoA cases.

Main Methods:

  • A 21-year retrospective analysis of percutaneous stent repair for complex coarctation of the aorta.
  • Inclusion criteria for complexity: aortic arch interruption, associated aneurysms, complex stenosis, or need for re-expansion/restenting.
  • Detailed analysis of patient demographics, procedural characteristics, and clinical outcomes.

Main Results:

  • The study included 58 patients with complex coarctation, with 33% having multiple complicating factors.
  • Two early deaths (3.4%) occurred within 1 month.
  • At a mean follow-up of 10 years, 95% of patients were symptom-free with normal blood pressure and patent aorta, achieving a 15-year actuarial survival of 92%.

Conclusions:

  • Percutaneous stent repair is a feasible and safe treatment for complex coarctation of the aorta.
  • The procedure demonstrates durable results with sustained patency and low rates of adverse events at long-term follow-up.
  • Stent repair provides a viable option for patients with challenging aortic arch anatomy and coarctation.
Abstract

Keywords:
aortic aneurysmcomplex coarctation of aortainterrupted aortic archstent re-expansionstent repair

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