Midterm to long‐term safety and efficacy of self‐expandable nitinol stent implantation for coarctation of aorta in adults

Zeinali, Ali Mohammad Haji; Sadeghian, Mohammad; Qureshi, Shakeel A.; Ghazi, Payam

doi:10.1002/ccd.27178

Cited by 19 publications

(13 citation statements)

References 37 publications

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“…20 In our study, stent migration during the procedure was reported in 4 patients from the native CoA group. Another known complication of stent implantation is the fracture of endovascular stents.…”

Section: Long -Term Follow -Upmentioning

confidence: 60%

Immediate and long term outcomes of native aortic coarctation and postsurgical aortic recoarctation treated with stent implantation: one Center experience

Sulik¹,

Fiszer²,

Scalone³

et al. 2017

Polish Archives of Internal Medicine

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INTRODUCTION Stent implantation has become the treatment of choice for native aortic coarctation (CoA) and postsurgical aortic recoarctation (reCoA) in adults and adolescents.OBJECTIVES This study aimed to compare the immediate and long -term outcomes of patients with native CoA and postsurgical reCoA who underwent stent implantation in our center. PATIENTS AND METHODSThe data of 136 patients with native CoA and reCoA who underwent stent implantation between May 1999 and December 2016 were retrospectively analyzed. The study population was divided into 2 groups: 108 patients with native CoA and 28 patients with reCoA. Clinical and procedural characteristics and immediate and long -term outcomes after the intervention were compared between the groups. The use of antihypertensive drugs was analyzed in all patients. RESULTSThere were no significant differences in the clinical characteristics of the study groups. The gradient before the intervention was significantly higher in the native CoA than in the reCoA group (P = 0.011), and the diameter of stenosis before the intervention was smaller in the native CoA group compared with the ReCoA group (P = 0.003). Procedural treatment was successful in 77.8% of the patients with native CoA and 78.5% of those with reCoA. There were no differences in the immediate and long -term outcomes between the groups. The antihypertensive treatment was tapered or discontinued in about 34% of the study population.CONCLUSIONS Stenting is an effective and safe procedure in patients with native CoA and reCoA, with good late outcomes.

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Section: Long -Term Follow -Upmentioning

confidence: 60%

Immediate and long term outcomes of native aortic coarctation and postsurgical aortic recoarctation treated with stent implantation: one Center experience

Sulik¹,

Fiszer²,

Scalone³

et al. 2017

Polish Archives of Internal Medicine

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“…Over the decades, the interventional stenting technology has achieved very fruitful clinical results in treatment of COA, [12,14,20,21] and has become the treatment of rst choice in adults in many centers. [22] However, the stents are not suitable for the coarctation located at the arch of which the curvature is too sharp.…”

Section: Discussionmentioning

confidence: 99%

“…[12,13] In spite of that, acute aortic wall injury is often a dramatic event of the stenting technique, and may be more frequent in elderly patients with highly calci ed tissue or hypoplastic vessels with reduced elasticity. [14] In contrast, extra-anatomic bypass could be feasible in all candidates irrespective of COA features.…”

Section: Introductionmentioning

confidence: 99%

Outcomes Of One-Staged Procedures To Treat Aortic Coarctation Complicated By Cardiac Anomalies

Lin

Chang

Qian

et al. 2022

Preprint

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Objective: One-staged surgical treatment of aortic coarctation combined with cardiac anomalies is challenging. We aim to evaluate the feasibility of bilateral aortofemoral bypass technique in one-staged surgery treating coractation by comparing surgical outcomes with catheter intervention plus stent(hybrid).Methods: Between January 2012 and December 2017, 50 patients underwent one-staged surgical procedures to treat coarctation and repair concomitant cardiac anomalies, like aortic root dilatation, cardiac valvular disease and so on. Among them, 30 patients underwent bilateral aortofemoral bypass and 20 patients underwent hybrid procedure to treat coarctation. We retrospectively analyzed the data of these patients and compared the early and late results. Results: All the baseline clinical characteristics were comparable between groups except that the mean age of bypass group was 39.5±14.0 years which was older than hybrid group (27.9±8.5 years, P=0.002). Technical success was achieved in all patients, with no hospital death or other severe complications. Immediately after surgery, in bypass and hybrid group, the mean upper-limb systolic blood pressure decreased from 159.4mmHg to 119.7mmHg and 148.4mmHg to 111.6mmHg, the median peak systolic gradient decreased from 68.0mmHg to 10mmHg and 46.5mmHg to 10mmHg respectively(P=0.09). And the mean upper-lower limbs gradient decreased from 21.7mmHg to 5.9mmHg and 21.0mmHg to 2.7mmHg respectively(P=0.104). The mean follow-up time was 76.92±18.7 in bypass group and 85.4±20.6 months in hybrid group. There were 4 late deaths in bypass group (one died of gastrointestinal bleeding, one died of pulmonary embolism and the other two died of heart failure caused by mechanical prosthetic valve dysfunction). The follow-up peak systolic gradient and other blood pressure parameters showed stable and no differences between two groups.Conclusions: The bilateral aortofemoral bypass surgery is a safe and effective method which can be used in one-staged surgical strategy to treat coarctation complicated by cardiac anomalies and can be an alternative to the hybrid method.

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“…Recently, the stenting technique has gradually replaced the traditional surgical correction of isolated COA in adult patients [ 12 ], attributing to its avoidance of the acute complications caused by thoracotomy and its satisfactory outcomes [ 12 , 13 ]. In spite of that, acute aortic wall injury is often a dramatic event of the stenting technique, and may be more frequent in elderly patients with highly calcified tissue or hypoplastic vessels with reduced elasticity [ 14 ]. In contrast, extra-anatomic bypass could be feasible in all candidates irrespective of COA features.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of one-staged procedures to treat aortic coarctation complicated by cardiac anomalies

Lin

Chang

Qian

et al. 2022

BMC Cardiovasc Disord

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Objective One-staged surgical treatment of aortic coarctation combined with cardiac anomalies is challenging. We aim to evaluate the feasibility of bilateral aortofemoral bypass technique in one-staged surgery treating coractation by comparing surgical outcomes with catheter intervention plus stent (hybrid). Methods Between January 2012 and December 2017, 50 patients underwent one-staged surgical procedures to treat coarctation and repair concomitant cardiac anomalies, like aortic root dilatation, cardiac valvular disease and so on. Among them, 30 patients underwent bilateral aortofemoral bypass and 20 patients underwent hybrid procedure to treat coarctation. We retrospectively analyzed the data of these patients and compared the early and late results. Results All the baseline clinical characteristics were comparable between groups except that the mean age of bypass group was 39.5 ± 14.0 years which was older than hybrid group (27.9 ± 8.5 years, P = 0.002). Technical success was achieved in all patients, with no hospital death or other severe complications. Immediately after surgery, in bypass and hybrid group, the mean upper-limb systolic blood pressure decreased from 159.4 to 119.7 mmHg and 148.4 to 111.6 mmHg, the median peak systolic gradient decreased from 68.0 to 10 mmHg and 46.5 to 10 mmHg respectively (P = 0.09). And the mean upper-lower limbs gradient decreased from 21.7 to 5.9 mmHg and 21.0 to 2.7 mmHg respectively (P = 0.104). The mean follow-up time was 76.92 ± 18.7 in bypass group and 85.4 ± 20.6 months in hybrid group. There were 4 late deaths in bypass group (one died of gastrointestinal bleeding, one died of pulmonary embolism and the other two died of heart failure caused by mechanical prosthetic valve dysfunction). The follow-up peak systolic gradient and other blood pressure parameters showed stable and no differences between two groups. Conclusions The bilateral aortofemoral bypass surgery is a safe and effective method which can be used in one-staged surgical strategy to treat coarctation complicated by cardiac anomalies and can be an alternative to the hybrid method.

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Midterm to long‐term safety and efficacy of self‐expandable nitinol stent implantation for coarctation of aorta in adults

Abstract: Self-expandable nitinol stents for the treatment of native and recurrent CoA is safe and has good efficacy with acceptable midterm to long-term outcome.

Cited by 19 publications

References 37 publications

Immediate and long term outcomes of native aortic coarctation and postsurgical aortic recoarctation treated with stent implantation: one Center experience

Immediate and long term outcomes of native aortic coarctation and postsurgical aortic recoarctation treated with stent implantation: one Center experience

Outcomes Of One-Staged Procedures To Treat Aortic Coarctation Complicated By Cardiac Anomalies

Outcomes of one-staged procedures to treat aortic coarctation complicated by cardiac anomalies

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