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Blood Pressure Behavior After Correction Adult Coarctation of Aorta Short Term Follows Up
Ali Yahya Abdullah Alsallami1, Khalid Amber2
1Department of Cardiology, Medical College, University of Kufa, Iraq.
Insights
Endovascular stenting is a safe and effective treatment for adult coarctation of the aorta (CoA), significantly lowering blood pressure and reducing complications. This study shows favorable outcomes with minimal aortic wall injury or aneurysm development post-procedure.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Imaging
Background:
- Coarctation of the aorta (CoA) is a common congenital heart defect that can lead to serious complications if untreated.
- Diagnosis can be challenging due to mild symptoms, with complications often appearing in the fourth decade of life.
- Treatment options include balloon dilation, stenting, and surgery.
Purpose of the Study:
- To evaluate the effectiveness of endovascular stenting in managing hypertension in adult patients with coarctation of the aorta.
- To assess short-term outcomes and potential complications following aortic stenting.
Main Methods:
- A prospective longitudinal study involving 75 adult patients (16-41 years) with coarctation of the aorta.
- Diagnosis confirmed by echocardiography and CT chest; all patients underwent aortic catheterization and stenting.
- Pressure gradients across the stenosis and stent were measured pre- and post-procedure.
Main Results:
- Immediate reduction in pressure gradient across the coarctation post-stenting was observed in nearly all patients.
- At 6-month follow-up (69 patients), 52% showed no aortic wall injury or aneurysm.
- At 1-year follow-up (45 patients), 24% showed no aortic wall injury or aneurysm.
Conclusions:
- Uncovered stents are a safe treatment for coarctation of the aorta, associated with low morbidity and mortality.
- Stenting in adult patients with coarctation of the aorta offers the advantage of lowering blood pressure in hypertensive individuals.
Background:
Coarctation of aorta (CoA) is a relatively common congenital cardiac defect often causing few symptoms and therefore can be challenging to diagnose. Usually, untreated CoA may lead to a renal, vascular and cardiac complication that starts to appear at beginning of the fourth decade of life. Several methods have been proved as a modality for the treatment of CoA like balloon dilation, stenting, and surgery, etc.
Objective:
To assess the hypertensive condition after endovascular stenting adult with CoA in short term follow up.
Methods:
We report the outcome in 75 patients, out of these 30 male patients (40%) and 45 female patients (60%) were involved in this prospective longitudinal study, their age range between 16 to 41 years. Stenting of simple coarctation was performed on 75 patients at the Cardiology consult department in Al-najaf cardiac center or from a private clinic between January 2018 to January 2019. For the treatment of all patients, echocardiography, CT chest done to confirm diagnosis then all undergo catheterization of aorta with two sheaths one femoral and other radial to measure pressure gradient across the stenosis and stent localization follow by stenting with pre and post-dilation if needed then measure pressure gradient across stent.
Results:
Out of 75 patients 69 patients (92%) returned for the 6-month follow-up evaluation and 53 patients (70%) returns for the 1-year follow-up evaluation with stent implantation, interrupted coarctation immediately after stent pressure gradient falls in almost all our patient. The patient returns at the time of 6 months and one year follow up, the assessment was done through CT angiography. At the time of six months, 39/69 patients (52%) and at the time of 1 year 18/45 patients (24%) show no aortic wall injury or aneurysm development.
Conclusion:
Uncovered stents appear to be safe in treating CoA with less morbidity and mortality. Stent adult with CoA hasthe advantage of lowering blood pressure in those suffering from hypertension.
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