Endovascular stent placement is an acceptable alternative to reoperation in selected infants with residual or recurrent aortic arch obstruction

Bentham, Jamie; Shettihalli, Naveen; Orchard, Elizabeth; Westaby, Stephen; Wilson, Neil

doi:10.1002/ccd.22586

Cited by 13 publications

(12 citation statements)

References 29 publications

(33 reference statements)

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“…Reported success rate ranges between 80% -100%. (5,6,(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) Our findings compare favourably with this. Overall, low periprocedural complication rates have been reported in stents used in older children (up to 16%).…”

Section: Discussionsupporting

confidence: 75%

“…However, as the group of patients is quite diverse, it is difficult to compare the overall mortality to a similar surgical series. (3)(4)(5)(6)(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) Mortality in surgical COA repairs in infants for example, is known to be much lower (<2%), but higher in small, complex patients (5 -25%). (3,12) It should be mentioned that one patient was sent home for palliative care and one patient had severe post-operative hypoxia and acidosis.…”

Section: Discussionmentioning

confidence: 99%

“…(14) Experience in stenting very young and small patients with critical obstructive congenital heart disease is limited and consists mostly of case reports and a few review articles. (5,6,(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) The majority reported good immediate results, but limited data on follow-up and final outcomes is available.…”

Section: Introductionmentioning

confidence: 99%

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The use of small stents to delay surgical intervention in very young children with critical congenital heart disease

Greig

Buys

Brown

et al. 2017

SAHJ

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The use of small stents to delay surgical intervention in very young children with critical congenital heart disease

Greig

Buys

Brown

et al. 2017

SAHJ

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“…Traditional stents have been tried with eventual redilation, but long-term outcomes of this approach are lacking [81, 82]. “Open-ring” or growth stents have been suggested as a way to implant stents in infants and young children [83, 84].…”

Section: Current and Future Transcatheter Therapiesmentioning

confidence: 99%

Coarctation of the Aorta - The Current State of Surgical and Transcatheter Therapies

Vergales¹,

Gangemi²,

Rhueban³

et al. 2013

CCR

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Aortic coarctation represents a distinct anatomic obstruction as blood moves from the ascending to the descending aorta and can present in a range of ages from infancy to adulthood. While it is often an isolated and discrete narrowing, it can also be seen in the more extreme scenario of severe arch hypoplasia as seen in the hypoplastic left heart syndrome or in conjunction with numerous other congenital heart defects. Since the first description of an anatomic surgical repair over sixty years ago, an evolution of both surgical and transcatheter therapies has occurred allowing clinicians to manage and treat this disease with excellent results and low morbidity and mortality. This review focuses on the current state of both transcatheter and surgical therapies, paying special attention to recent data on long-term follow-up of both approaches. Further, current thoughts will be explored about future therapeutic options that attempt to improve upon historical long-term outcomes.

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“…Additionally, neonates often have transverse arch hypoplasia, which does not easily lend itself to endovascular stent placement. Some small, single center studies have had positive shortterm results with endovascular stent placement in young children, but further followup and investigation is needed [71,72] . Covered endovascular stents represent the latest transcatheter innovation and were first used for the treatment of coarctation in 1999.…”

Section: Patient Follow-upmentioning

confidence: 99%

Coarctation of the aorta: Management from infancy to adulthood

Török

Campbell

Fleming

et al. 2015

WJC

235

151

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Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

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Endovascular stent placement is an acceptable alternative to reoperation in selected infants with residual or recurrent aortic arch obstruction

Abstract: Endovascular stent placement in infants is technically feasible with good results achievable even in small babies. It should be considered as a therapeutic option in complex cases when surgical alternatives are less favorable.

Cited by 13 publications

References 29 publications

The use of small stents to delay surgical intervention in very young children with critical congenital heart disease

The use of small stents to delay surgical intervention in very young children with critical congenital heart disease

Coarctation of the Aorta - The Current State of Surgical and Transcatheter Therapies

Coarctation of the aorta: Management from infancy to adulthood

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