Impact of Transcatheter Intervention on Myocardial Deformation in Patients with Coarctation of the Aorta

Abstract Background CoA is associated with hypertension caused by reduced wind kessel function in the aortic arch, general hypoplasia of the arch and/or essential hypertension. In patients with a native or recurrent/rest CoA, a gradient >20 mmHg by non-invasive meassurement if associated with hypertension is an ESCguideline indication for intervention. We studied the persistence and presence of hypertension after transcatheter intervention of a CoA Methods All consecutive patients undergoing catheter interventions for CoA from 1st of January 2000 to 31st of December 2016 were identified by each of the particpating nine centers. The nine centers perform all catheter interventions for CoA for a complete population coverage of 25 millions inhabitants. A common protocoll was filled out from medical records. Hypertension was defined as a pre-intervention blood pressure above 140/80 or pharmacological treatment of hypertension. Exclusion criteria were weight less than 20 kg at the time of intervention or Norwood surgery Results 590 interventions were performed on 520 patients: two interventions n=76, three: n=11, four n=2 and one patient underwent five interventions. Before intervention, 437 (74%) of the patients were hypertensive and 285 were on pharmacologocal treatment; 134 (48%) were treated with one drug, 79 patients (28%) with two drugs, 41 patients (15%) with three drugs and 14 (5%) with four drugs. After the intervention during follow up hypertension was present in 294 patients (50%, p<0.001 vs pre) of whom 270 (46%) were on pharmacological treatment; with one drug, n=128 (48%), two drugs n=93 (34%), three drugs n=34 (13%) or 4 drugs n=7 (3%). Conclusions Catheter intervention of CoA reduced the presence of hypertension significantly from 74% down to 50% but many patients will remain hypertensive and in need for treatment. Life time follow up also after transcatheter CoA intervention seems warranted. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): ALF-LUA, Heart and Lung Foundation

Download Full-text

OP05.04: Incremental value of myocardial deformation in predicting postnatal coarctation of the aorta: establishment of a novel diagnostic model

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.23965 ◽

2021 ◽

Vol 58 (S1) ◽

pp. 74-74

Author(s):

J. Liu ◽

H. Cao ◽

L. Hong ◽

L. Cui ◽

L. Zhang ◽

...

Keyword(s):

Coarctation Of The Aorta ◽

Myocardial Deformation ◽

Diagnostic Model ◽

Incremental Value

Download Full-text

Re: Myocardial deformation in fetuses with coarctation of the aorta: a case-control study. J. O. Miranda, L. Hunter, S. Tibby, G. Sharland, O. Miller and J. M. Simpson. Ultrasound Obstet Gynecol 2017; 49: 623-629.

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.17472 ◽

2017 ◽

Vol 49 (5) ◽

pp. 565-565 ◽

Cited By ~ 1

Author(s):

F. Crispi

Keyword(s):

Obstet Gynecol ◽

Case Control Study ◽

Coarctation Of The Aorta ◽

Case Control ◽

Myocardial Deformation ◽

Control Study

Download Full-text

Hybrid Surgical Repair for Recurrent Coarctation of the Transvers Arch: Case Report

10.22541/au.162595593.30345023/v1 ◽

2021 ◽

Author(s):

Kıvanc ATILGAN ◽

Alper TOSYA ◽

Fahri YEŞİL ◽

Pinar Koksal Coskun ◽

Burak ONUK ◽

...

Keyword(s):

Stent Placement ◽

Carotid Arteries ◽

Surgical Repair ◽

Median Sternotomy ◽

Coarctation Of The Aorta ◽

Complete Relief ◽

Hybrid Technique ◽

Transcatheter Intervention ◽

Transverse Arch ◽

Common Carotid Arteries

The incidence of postoperative recurrent coarctation of the aorta ranges from 5% to 50%, and largely depends on the age at initial repair. Due to the increased fibrosity and rigidity of the aorta in older age, stent placement is preferred instead of balloon angioplasty, resulting in an almost complete relief of the gradient in >95% of the patients. In patients with transverse arch hypoplasia, transcatheter intervention with further surgical intervention may be needed, and the use of stenting was shown to be effective in the treatment of patients with hypoplastic isthmus, arch or tubular coarctation. In this case of a late re-coarctation, we preferred to apply a hybrid technique for treatment. The first step of the treatment was debranching of the brachiocephalic and left common carotid arteries with upper mini median sternotomy. On the following day, the patient underwent a successful stent placement to the transvers arch.

Download Full-text

Late diagnosis of coarctation of the aorta in a 44-year-old male: a case report

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01753-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Weijian Luo ◽

Jilin Li ◽

Xiaojun Huang ◽

Xiangna Cai

Keyword(s):

Ventricular Hypertrophy ◽

Good Condition ◽

Coarctation Of The Aorta ◽

Left Ventricular ◽

Late Diagnosis ◽

Transcatheter Intervention ◽

Case Presentation ◽

Include Blood Pressure ◽

Upper And Lower Extremities

Abstract Background Coarctation of the aorta is a rare congenital disease. In adults, the main manifestations include hypertension, weak or absent femoral pulses, heart failure, and left ventricular hypertrophy. Case presentation We present a case involving a late diagnosis of coarctation of the aorta detected during aortography in a 44-year-old man. The patient underwent stent implantation and aortoplasty. After 2 years of follow-up, the patient was in good condition. Conclusions This case shows that coarctation of the aorta can be cured and that hypertension caused by the condition can be controlled to some extent with medication. Based on our findings, we recommend a detailed physical examination for all patients suspected of having coarctation of the aorta; the examination should include blood pressure measurements of both the upper and lower extremities. The case of coarctation of the aorta is not common or easy to be found in medium-aged population. Better BP control, earlier repair, and transcatheter intervention may result in a good outcome in that case.

Download Full-text