Thoracic Stent Grafts Induce Persistent Aortic Remodeling in Aortic Coarctation

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Medicine

Background:

• Aortic coarctation is a congenital heart defect requiring treatment in adulthood.
• Primary or recurrent aortic coarctation presents significant challenges in adult patients.
• Thoracic stent graft placement is an emerging treatment option for aortic coarctation.

Purpose of the Study:

• To evaluate the outcomes of thoracic stent graft placement in adult patients with aortic coarctation.
• To assess the safety and efficacy of stent graft repair for primary or recurrent aortic coarctation.
• To describe the long-term results of endovascular repair in this patient population.

Main Methods:

• Retrospective analysis of 30 adult patients undergoing thoracic stent graft repair for aortic coarctation.
• Utilized MDT and GORE TAG stent grafts for the endovascular repair.
• Patient data collected included demographics, indications for repair, and follow-up outcomes.

Main Results:

• Significant reduction in the pressure gradient across the coarctation post-treatment (P < 0.0001).
• Observed significant increases in aortic coarctation diameter and aortic remodeling up to 5 years post-procedure.
• Sustained improvements in systolic, diastolic, and mean arterial pressure observed up to 1 year post-treatment.

Conclusions:

• Thoracic stent graft placement is a safe and effective treatment for adult aortic coarctation.
• The procedure leads to clinically significant blood pressure improvement.
• Longitudinal aortic remodeling of the coarctation segment and aorta persists beyond 3 years.