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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
Summary
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.
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