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Catheter Cardiovasc Interv. 2006 Feb;67(2):268-75.

Endovascular aortic coarctation stenting in adolescents and adults: angiographic and hemodynamic outcomes.

Author information

1
Adult Congenital Heart Unit, Royal Brompton Hospital, London, SW3 6NP, United Kingdom. viakom.mahadevan@cmmc.nhs.uk

Abstract

OBJECTIVES:

To assess the procedural, clinical, angiographic, and hemodynamic outcomes, including ambulatory blood pressure monitoring at 1 year in adolescent and adult patients undergoing primary stenting for treatment of aortic coarctation.

BACKGROUND:

Stenting is widely used for treatment of aortic coarctation. Data regarding efficacy of this treatment for control of hypertension at 1 year is scant, with only one reported series of planned angiographic follow up. The impact of newer type stents for this procedure is also unknown.

METHODS:

Thirty-seven patients undergoing stenting for aortic coarctation, over a 3-year period in a tertiary centre were studied as part of an observational protocol.

RESULTS:

Peak gradient across the coarctation fell from 28.3 +/- 15.1 to 3.7 +/- 4.1 post procedure and was 11.9 +/- 8.9 mmHg (P < 0.05 compared to baseline) at 1 year. There was one major complication (2.7%), with no deaths. Small aneurysms were seen in three patients (13%) on follow up angiography at 1 year. Right arm systolic blood pressures fell from 155 +/- 19 to 132 +/- 22 (P < 0.05) at 6 weeks and was 132 +/- 16 mmHg (P < 0.05 compared to baseline) at 1 year. Ambulatory average systolic blood pressures fell from 142 +/- 14 to 133 +/- 15 at 6 weeks (P < 0.05) and to 125 +/- 12 mmHg (P < 0.05 compared to baseline) at 1 year. No significant differences were seen in procedural outcomes between patients receiving Palmaz and CPNumed stents.

CONCLUSION:

Primary stenting of aortic coarctation in adolescents and adults results in excellent clinical and angiographic outcomes and sustained hemodynamic benefits at 1 year as evidenced by significant reduction in systolic blood pressure and gradients. Close follow up is required to monitor aneurysm formation.

PMID:
16400666
DOI:
10.1002/ccd.20585
[Indexed for MEDLINE]

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