Comparison of surgical repair with balloon angioplasty for native coarctation in patients from 3 months to 16 years of age

Walhout, Ronald J; Lekkerkerker, Jaco C; Oron, Gordon H; Bennink, Ger B.W.E.; Meijboom, Erik J.

doi:10.1016/j.ejcts.2004.04.008

Cited by 57 publications

(40 citation statements)

References 22 publications

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“…The surgical mortality in this historical material was high compared with recent series [13,17], but equals what has been reported in other older studies [18]. The surgical deaths occurred mainly in infants with complex associated lesions indicating that surgical treatment of CoA in children and adults in itself was performed with low risk during that period.…”

Section: Surgical Mortalitysupporting

confidence: 66%

“…The surgical deaths occurred mainly in infants with complex associated lesions indicating that surgical treatment of CoA in children and adults in itself was performed with low risk during that period. The not significantly higher surgical mortality in the late decade compared with the early decade reflects more infants with complex associated lesions in the late decade, even though the degree of severity of the associated lesions was minor compared with recent series of CoA patients [17]. Sex and surgical technique had no significant influence on surgical or late mortality.…”

Section: Surgical Mortalitymentioning

confidence: 86%

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Surgical repair of coarctation of the aorta: up to 40 years of follow-up

Høimyr

Christensen

Emmertsen

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Section: Surgical Mortalitysupporting

confidence: 66%

Section: Surgical Mortalitymentioning

confidence: 86%

Surgical repair of coarctation of the aorta: up to 40 years of follow-up

Høimyr

Christensen

Emmertsen

et al. 2006

European Journal of Cardio-Thoracic Surgery

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“…In 2004, Walhout et al [84] performed retrospective review and comparison of surgical repair with balloon angioplasty for native coarctation in 46 patients and found similar immediate success with respect to decrease in pressure gradients and recoarctation rates and freedom from reintervention at follow-up. No aneurysms were seen in either group.…”

Section: Comparison Of Different Treatment Modalitiesmentioning

confidence: 99%

Coarctation of Aorta-Management Options and Decision Making

Doshi¹

2012

Pediat Therapeut

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Coarctation of the Aorta (CoA) is a congenital cardiac anomaly consisting of a constricted aortic segment with a prevalence of 5 to 8% of all Congenital Heart Defects (CHD). The classic CoA is located in the thoracic aorta distal to the origin of the left subclavian artery, at about the level of the ductal structure. Significant hypertension and/or congestive heart failure are indications of intervention. If hypertension (rather that heart failure) is the clinical problem, it is better to relieve the aortic obstruction promptly rather that attempting to "treat" hypertension with antihypertensive medications. Surgical relief of the aortic obstruction and catheter interventional techniques (balloon angioplasty and stents) are available alternatives. Since the introduction of surgical correction by Crafoord and Nylin and Gross and Hufnagel in early 1940s, surgical therapy has been the treatment of choice for aortic coarctation. Gruntzig's technique of balloon angioplasty was adopted by Singer and Sperling and their associates to enlarge coarcted aortic segments in post-surgical recoarctation and native coarctation, respectively in early 1980s. This is followed by the application of the technique by other cardiologists to treat native CoA. The procedure consists of inserting a balloon angioplasty catheter across the site of coarctation and inflating the balloon with diluted contrast material. Both immediate and followup results are reasonably good. Residual and recurrent obstructions following surgery and prior balloon angioplasty are also amenable for balloon angioplasty. Despite reasonably good short-term and long-term results of balloon angioplasty, some problems remain and include restenosis, probability of aortic rupture, formation of aneurysms and inability to effectively treat long-segment tubular narrowing. Because of these and other reasons, endovascular stenting of aortic coarctation has gained acceptance over the last decade. The balloon catheter, with the stent mounted on it, is advanced over a stiff guide wire and positioned across the coarctation segment and the balloon inflated, thus implanting the stent. Most cardiologists use stents in adolescents and adults and restrict their use in younger children because of issues related to growth. Stent therapy appears to be an attractive method for treatment of native or recurrent coarctation, aneurysm formation following prior surgical or balloon intervention and for long segment hypoplasia. Role of covered stents to manage aortic coarctation is limited and are used when the assessed risk for development of aneurysm or dissection is high. A comparison of all available treatment modalities was made and while it is difficult to make a definitive statement, the overall data seem to indicate that transcatheter methods may be better than surgery. Selection of the method of therapy is largely based on the age at presentation and anatomy of the coarcted segment and surrounding structures; surgery for infants and long segment coarctations, balloon angioplast...

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“…Complications include retroperitoneal bleeding (3%), device embolization (3%), aortic dissection or rupture (1-5%), stent migration (6%), coronary artery injury with subsequent myocardial infarction, postinterventional formation of arteriovenous fistulas (3%) and unplanned occlusion of the left subclavian artery that may necessitate post-interventional left carotidsubclavian bypass (52,(59)(60)(61)91,97,99,100).…”

Section: Techniques For Re-interventionmentioning

confidence: 99%

Coarctation repair—redo challenges in the adults: what to do?

Beckmann

Jassar

2018

J. Vis. Surg.

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Aortic coarctation is one of the most common congenital cardiac pathologies. Repair of native aortic coarctation is nowadays a common and safe procedure. However, late complications, including recoarctation and aneurysm formation, are not uncommon. The incidence of these complications is dependent on the type of the initial operation. Both endovascular and conventional open repair play important roles in the treatment of late complications after previous coarctation repair. This article will review the incidence of late complications after coarctation repair and will discuss the treatment options for redo coarctation repair in adult patients.

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Comparison of surgical repair with balloon angioplasty for native coarctation in patients from 3 months to 16 years of age

Abstract: Both surgical repair and BA for native coarctation yield low reintervention probabilities in comparable patients. Aneurysm formation was not encountered following different treatment types.

Cited by 57 publications

References 22 publications

Surgical repair of coarctation of the aorta: up to 40 years of follow-up

Surgical repair of coarctation of the aorta: up to 40 years of follow-up

Coarctation of Aorta-Management Options and Decision Making

Coarctation repair—redo challenges in the adults: what to do?

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