Immediate and midterm results of balloon angioplasty for recurrent aortic coarctation in children aged &lt; 1 year

Lefort, Bruno; Lachaud, Matthias; Arid, Jean Marc El; Neville, Paul; Soulé, Nathalie; Guérin, Patrice; Chantepîe, A.

doi:10.1016/j.acvd.2017.05.007

Cited by 9 publications

(3 citation statements)

References 25 publications

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“…Overall, arch reobstruction was a common occurrence after reintervention. The incidence of arch reobstruction has been reported to range from 15.0 to 40.0% after BA 13,17,20,21 and 0 to 28% after surgical repair. 8 At our center, the rate of arch reobstruction was similar to what has been observed in other studies; 30.0% of patients with BA and 15.0% of patients with surgical repair had arch reobstruction after reintervention.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Arch Reintervention for Recurrent Coarctation in Young Children

Jiang

Dong

et al. 2021

Thorac Cardiovasc Surg

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Objectives To evaluate the outcomes of reintervention for postrepair recoarctation in young children. Methods Between January 2011 and December 2020, all consecutive patients aged ≤3 years who were treated for postrepair recoarctation were included. Recoarctations were classified into two morphological types by three-dimensional imaging. Two methods, namely, surgical repair and balloon angioplasty (BA), were used to treat recoarctation. Results This study included 50 patients with a median age of 10.5 months (range, 2.0–36.0 months) and a mean weight of 9.3 ± 3.1 kg. Hypoplastic recoarctation occurred most frequently in patients who had undergone patch aortoplasty at initial repair (p = 0.001). No hospital mortality occurred, and all patients achieved an increased diameter (p < 0.001) and a decreased pressure gradient (p < 0.001) at the recoarctation site immediately after reintervention. The median follow-up time after reintervention was 3.5 years (range, 16.0 days–9.6 years). Late mortality occurred in four patients (8.0%): two in the surgical group and two in the BA group (chi-square test= 0.414, p = 0.520). There was no difference in arch reobstruction after reintervention between the surgical and BA groups (chi-square test = 1.383, p = 0.240). Recoarctation with a hypoplastic morphology was the leading risk factor for arch reobstruction after reintervention (hazard ratio, 6.552; 95% confidence interval, 2.045–20.992; p = 0.002). Conclusion Reintervention for recoarctation has favorable early outcomes in young children. However, late mortality is not rare, and arch reobstruction is common during close follow-up. For young children, recoarctation with hypoplastic morphology is the leading risk factor for reobstruction, while the choice of reintervention method exerts little effect on the outcomes of arch reintervention.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Arch Reintervention for Recurrent Coarctation in Young Children

Jiang

Dong

et al. 2021

Thorac Cardiovasc Surg

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“…Of course, technical considerations include the choice of sheaths, catheters and stents. The smallest sheath possible should be chosen to avoid access problems, which have been described previously [3]. Through the sheath, angiography even with dilute contrast can visualise the whole aorta, avoiding manipulation with a catheter.…”

Section: Discussionmentioning

confidence: 99%

“…Stenting of coarctation of the aorta (CoA) is well established in adults and children weighing more than 25 kg, but even in smaller children this technique is gaining acceptance [1,2]. In smaller children aged 3 months or more, ballooning is a treatment option for native and recurrent CoA [3], but there are recent reports of even smaller patients undergoing stent therapy as either a bridge to operation or as primary treatment [4][5][6][7][8][9]. Stenting of coarctations in small children has been carried out for several reasons in a limited number of patients [4][5][6][7][8]10].…”

Section: Introductionmentioning

confidence: 99%

Indications for stenting of coarctation of the aorta in children under 3 months of age

et al. 2020

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Introduction Coarctation of the aorta in children under 3 months of age is usually treated surgically. However, there are clinical scenarios in which stenting of native or recurrent coarctation may become necessary in this age group. Case reports Four cases illustrate possible indications: left ventricular dysfunction increasing the operative risk, thrombus formation after coarctation surgery, patient size (i.e. in premature babies), and retrograde arch obstruction after hybrid palliation of hypoplastic left heart syndrome. In all babies, coarctation stenting was carried out successfully without complications. Conclusion Coarctation stenting can be carried out safely in small children. Usually, the stent has to be removed or redilated later. Results are encouraging.

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