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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Transverse arch stenting and its effect on systemic hypertension.

İbrahim Halil Demir1, Murat Kardas1, İlker Kemal Yucel1

  • 1Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye.

Turk Gogus Kalp Damar Cerrahisi Dergisi
|June 27, 2024
PubMed
Summary

Transverse aortic arch stenting is a safe and effective treatment for hypertension in pediatric patients. The procedure significantly improves blood pressure control and reduces the need for antihypertensive medications.

Keywords:
Aortic arch stentingcoarctation.hypertension

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Systemic hypertension can persist after coarctation treatment due to residual transverse aortic arch lesions.
  • Transverse aortic arch stenting is a potential intervention for managing such cases.

Purpose of the Study:

  • To investigate the safety and efficacy of transverse aortic arch stenting.
  • To evaluate the impact of arch stenting on systemic hypertension.

Main Methods:

  • Retrospective analysis of 18 patients (age 4-23 years) who underwent transverse aortic arch stenting between 2007 and 2023.
  • Detailed examination of procedural data, technical aspects, pressure measurements, and outcomes.
  • Assessment of early and mid-term results, including complications and blood pressure control.

Main Results:

  • Stenting significantly increased aortic arch diameter and reduced pressure gradients.
  • No early mortality or major complications; one case of late stent migration.
  • Three patients became normotensive post-intervention, and five became drug-free during follow-up.

Conclusions:

  • Transverse aortic arch stent implantation is safe and effective, improving blood pressure control.
  • Patients require lifelong monitoring due to the risk of persistent hypertension.
  • Favorable outcomes suggest stenting as a viable option for managing residual arch lesions contributing to hypertension.