Late follow-up of balloon angioplasty in children with a native coarctation of the aorta

Lina Gumbienė, Sigitas Čibiras, Alicija Dranenkienė, Živilė Katliorienė, Giedrė Nogienė, Eugenijus KosinskasVilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Aprašomas naujo metodo – balioninės angioplastikos ir kraujagyslinių stentų – pritaikymas gydant aortos rekoarktaciją, atsiradusią po chirurginės ydos korekcijos. Ligoniai ir metodai Atlikta retrospektyvi duomenų analizė dešimties ligonių, kuriems Vilniaus universiteto Širdies chirurgijos centre 1994–2006 metais aortos rekoarktacija buvo gydyta balionine angioplastika ar stentavimu. Aprašoma centre taikyta aortos angioplastikos ir stentų implantavimo metodika. Rezultatai Aortos rekoarktacijos angioplastika atlikta keturiems ligoniams. Intraaortinis gradientas aortos koarktacijos vietoje po procedūros sumažėjo vidutiniškai 82,15%. Vėlyvuoju stebėjimo periodu (vid. 6,14 ± 5,2 metai) rekoarktacija buvo trims ligoniams. Aortos rekoarktacijos stentavimas atliktas septyniems ligoniams, vienam iš jų dėl atsinaujinusios rekoarktacijos po angioplastikos. Dviem ligoniams procedūra nepavyko. Kitiems penkiems ligoniams intraaortinis gradientas reAoCo vietoje vidutiniškai sumažėjo nuo 29,6 ± 11,6 mm Hg iki 2,6 ± 3,7 mm Hg. Stebėjimo laikotarpiu 0,58–3,75 metų po procedūros rekoarktacija nustatyta tik vienam ligoniui. Jam atliktas stento plėtimas. Išvada Perkateterinė balioninė angioplastika ir balionais išplečiami kraujagysliniai stentai veiksmingi ir saugūs aortos rekoarktacijų gydymo metodai. Pagrindiniai žodžiai: aortos koarktacija, rekoarktacija, perkateterinis gydymas Treatment of recurrent coarctation of the aorta employing balloon angioplasty and endovascular stents Lina Gumbienė, Sigitas Čibiras, Alicija Dranenkienė, Živilė Katliorienė, Giedrė Nogienė, Eugenijus KosinskasVilnius University, Centre of Heart Surgery, Santariškių g. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objective We present a new method of treatment – balloon angioplasty and endovascular stent – for patients with aortic re-coarctation following surgical correction. Patients and methods Ten patients with re-coarctation of the aorta after surgery underwent balloon angioplasty or stent implantation at Vilnius University Heart Surgery Centre in 1994–2006. Results Balloon angioplasty was performed in 4 patients. The intraaortic gradient in the site of coarctation decreased on average by 82.15% after the procedure. Re-coarctation developed in 3 patients in the late follow-up period (mean 6.14 ± 5.2 years). Stents were implanted in 7 patients (one developed re-coarctation after angioplasty). The procedure failed in two. The intraaortic gradient at the site of re-coarctation decreased on average from 29.6 ± 11.6 mm Hg to 2.6 ± 3.7 mm Hg. Re-coarctation was diagnosed only in one patient during the follow-up (0.58–3.75 years), and stent dilatation was performed in this case. Conclusions Balloon angioplasty and endovascular stents are effective and safe methods for the treatment of re-coarctation of the aorta. Key words: coarctation of the aorta, recurrent coarctation, transcatheter treatment

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Balloon angioplasty of native coarctation of the aorta: Midterm follow-up and prognostic factors

Journal of the American College of Cardiology ◽

10.1016/0735-1097(94)00437-u ◽

1995 ◽

Vol 25 (3) ◽

pp. 730-734 ◽

Cited By ~ 127

Author(s):

Scott E. Fletcher ◽

Michael R. Nihill ◽

Ronald G. Grifka ◽

Martin P. O'Laughlin ◽

Charles E. Mullins

Keyword(s):

Prognostic Factors ◽

Balloon Angioplasty ◽

Coarctation Of The Aorta

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Angiographic follow-up after balloon angioplasty for coarctation of the aorta

Journal of the American College of Cardiology ◽

10.1016/0735-1097(89)90612-8 ◽

1989 ◽

Vol 13 (3) ◽

pp. 689-695 ◽

Cited By ~ 59

Author(s):

Jose Suarez De Lezo ◽

Manuel Sancho ◽

Manuel Pan ◽

Miguel Romero ◽

Carmen Olivera ◽

...

Keyword(s):

Balloon Angioplasty ◽

Coarctation Of The Aorta

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Balloon angioplasty for isolated coarctation of the aorta with mirror image right aortic arch in an infant

Cardiology in the Young ◽

10.1017/s1047951100004510 ◽

1997 ◽

Vol 7 (4) ◽

pp. 458-461 ◽

Cited By ~ 2

Author(s):

Shinichi Tsubata ◽

Fukiko Ichida ◽

Toshio Miyawaki

Keyword(s):

Aortic Arch ◽

Balloon Angioplasty ◽

Myocardial Dysfunction ◽

Coarctation Of The Aorta ◽

Left Ventricular ◽

Mirror Image ◽

Right Aortic Arch ◽

Residual Pressure ◽

Infant Case

AbstractWe report the first infant case with coarctation of the aorta and mirror image right aortic arch, who presented with severe myocardial dysfunction and underwent successful balloon angioplasty for relief of coarctation, avoiding anesthetic and surgical risk. A follow-up cardiac cathetelization revealed no residual pressure gradient and continued angiographic improvement with excellent restoration in left ventricular function.

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The immediate and late results for balloon angioplasty of native coarctation of aorta in pediatrics age group

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v16i2.259 ◽

2020 ◽

Vol 16 (2) ◽

pp. 16-20

Author(s):

Maitham Qasim Mohammed ◽

Husam Thaaban Al-Zuhairi ◽

Ameer Adnan Muhsen ◽

Sadiq M. Al Hamash

Keyword(s):

Balloon Angioplasty ◽

Balloon Dilation ◽

Coarctation Of The Aorta ◽

Late Result ◽

Heart Catheterization ◽

Coarctation Of Aorta ◽

Transverse Arch ◽

Associated Lesions ◽

Percutaneous Balloon

Background: percutaneous balloon dilation of corotation of aorta is a less invasive and alternative to surgical repair for patients with discrete coaction of aorta and although the used of balloon angioplasty in patients with recurrent postoperative coarctation gained a wide consensus, the use this technique for native coarctation is still controversial in children less one years. Objective: to evaluate the immediate and late result of balloon dilation of native coarctation of aorta in infant and children. Type of the study: A prospective study. Subjects & Methods: The study was done on forty-five patients who were referred for cardiac catheterization and balloon angioplasty of native coarctation of the aorta at Ibn-AL-Bitar center for cardiac surgery between January 2015 to May 2016.Left heart catheterization was performed with evaluation of the morphology and pressure gradient across the stenotic segment of aorta. Follow up evaluations were done between 1 week and 18 months after discharge (mean 6 months) with transthoracic echocardiography. Results: The age of patients range from 1month to 4 years (median age at time of procedure was12.3month). Associated lesions in 11 patients (24.4%). Immediate results were reduction in gradient from 42.5± 17.3 to 10.3± 8.2 mm Hg in forty-two patients (93.3%). Late result during follow up period, 29 patients (69%) had maintain gradient less than 20mmHg. Complications were reported in 6 patients (13.3%). there was one procedure related death (2.2%). Conclusions: Balloon angioplasty for treatment of native coarctation of the aorta is effective with sustained benefit on long-term follow-up in infants and children >6 months. Transverse arch hypoplasia and children <6 months old has major effect on late outcome of recurrent coarctation of aorta.

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Long-term effects of balloon angioplasty on left ventricular hypertrophy in adolescent and adult patients with native coarctation of the aorta. Up to 18 years follow-up results

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.21287 ◽

2007 ◽

Vol 70 (6) ◽

pp. 881-886 ◽

Cited By ~ 21

Author(s):

Walid Hassan ◽

Mahmoud Awad ◽

Mohamed Eid Fawzy ◽

Ahmad Al Omrani ◽

Shahid Malik ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Balloon Angioplasty ◽

Ventricular Hypertrophy ◽

Coarctation Of The Aorta ◽

Left Ventricular ◽

Adult Patients ◽

Long Term Effects

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Percutaneous Implantation of Adult Sized Stents for Coarctation of the Aorta in Children ≤20 kg

Circulation Cardiovascular Interventions ◽

10.1161/circinterventions.120.009399 ◽

2021 ◽

Vol 14 (2) ◽

Author(s):

Brian A. Boe ◽

Aimee K. Armstrong ◽

Sarah A. Janse ◽

Eméfah C. Loccoh ◽

Katie Stockmaster ◽

...

Keyword(s):

Blood Pressure ◽

Balloon Angioplasty ◽

Surgical Intervention ◽

Arterial Occlusion ◽

Coarctation Of The Aorta ◽

Stent Fracture ◽

Single Center ◽

Minimum Diameter ◽

Technical Factors

Background: Stent implantation (SI) is more effective than balloon angioplasty for the treatment of coarctation of the aorta (CoA). Due to technical factors, balloon angioplasty is more commonly performed in small patients. We sought to evaluate outcomes of percutaneous adult sized SI for the treatment of CoA in small patients. Methods: A single-center retrospective review of all patients ≤20 kg who underwent percutaneous adult sized SI for native or recurrent CoA from 2004 to 2015 was performed. Results: Thirty-nine patients (20 patients ≤10 kg) were identified, with 28 (71.8%) having recurrent CoA and 22 (56.4%) previously failed balloon angioplasty. At the time of SI, the median (range) patient age and weight were 1.1 (0.3–7.9) years and 10 (5.5–20.4) kg, respectively. SI resulted in significant improvements in the median gradient (26 mm Hg [interquartile range (IQR), 18–42] to 0 mm Hg [IQR, 0–2]; P < 0.05) and median minimum diameter (3.6 mm [IQR, 2.4–4.8] to 7.7 mm [IQR, 6.5–9.4]; P <0.05). Seven patients (18%) had procedural adverse events. Twenty-seven (69%) patients underwent elective reintervention at a median time of 49.3 (IQR, 26.5–63.2) months from SI, with 8 (21%) stents requiring repeat SI for stent fracture. Over a median follow-up of 67.2 (IQR, 33.8–116.1) months, 25 patients (69%) were without hypertension or blood pressure gradient. Three (11%) patients developed femoral arterial occlusion. Conclusions: Adult sized SI is an alternative to surgical intervention for small patients with CoA. SI carries a risk of access-related complications, which may improve with the development of lower profile stents with adult sized maximum diameters.

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