Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study

Martins, José Diogo Ferreira; Zachariah, Justin P.; Tierney, ElifSeda Selamet; Truong, Uyen; Morris, Shaine A.; Kutty, Shelby; Ferranti, Sarah D. de; Rhodes, Jonathan; Antonio, Marta de; Thomas, Boban; Oliveira, Daniel P. S.; Jalles, Nuno; Geva, Tal; Carmo, Miguel Mota; Prakash, Ashwin

doi:10.4103/apc.apc_64_18

Cited by 3 publications

(1 citation statement)

References 60 publications

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“…Coarctation of the aorta (CoA) is an unusual congenital heart defect, which accounts for 5-8% in all congenital heart diseases (1)(2)(3). The most commonly associated intracardiac defect of CoA is the ventricular septal defect (VSD) (4,5).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Surgical Repair for Coarctation of the Aorta With Intracardiac Defects: A Single Center Experience Based on 93 Infants

et al. 2020

Front. Pediatr.

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Introduction: This study aims to summarize the clinical characteristics of coarctation of the aorta (CoA) associated with intracardiac anomalies in infants. Methods: Medical records of 93 infants who were diagnosed with CoA and intracardiac anomalies from August 2009 to August 2018 were retrospectively reviewed. Results: All of the 93 infants underwent single-stage repair for CoA associated with intracardiac anomalies. The mean operative time was 264.6 ± 57.1 min, and the time of ICU stay was 7.0 ± 4.1 days. The residual transcoarctation pressure gradient before discharge was lower than the pressure gradient prior to surgery (48.3 ± 17.5 vs. 22.4 ± 9.6 mmHg, P < 0.01). Early death before discharge was found in five infants. The mean follow-up time of 88 hospital survivors was 40.0 ± 26.4 months, and no subsequent death occurred in the follow-up. Transcoarctation pressure gradient of the 88 survivors in their last follow-up was 19.6 ± 10.5 mmHg. The pressure gradient of 27 cases was higher than 20 mmHg. Significant lower limb retardation was observed in four cases; therefore, balloon angioplasty consult was recommended. The cumulative recoarctation-free survival rate in 3-year follow-up was 73.5%. Conclusions: To avoid secondary operations in early period, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes in early to mid-term follow-up were satisfactory.

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Section: Introductionmentioning

confidence: 99%

Diagnosis and Surgical Repair for Coarctation of the Aorta With Intracardiac Defects: A Single Center Experience Based on 93 Infants

et al. 2020

Front. Pediatr.

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Prediction of post-stenting biomechanics in coarcted aortas: A pilot finite element study

Caimi

Pasquali

Sturla

et al. 2020

Journal of Biomechanics

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Impact of Treatment Modality on Vascular Function in Coarctation of the Aorta: The LOVE‐COARCT Study

Martins

Zachariah

Tierney

et al. 2019

JAHA

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Background Optimally treated patients with coarctation of the aorta remain at risk for late vascular dysfunction. The effect of treatment modality on vascular function is unknown. The LOVE‐COARCT (Long‐term Outcomes and Vascular Evaluation After Successful Coarctation of the Aorta Treatment) study was done to compare vascular function in patients with coarctation of the aorta treated with surgery, balloon dilation (BD), or stent implantation. Methods and Results In treated coarctation of the aorta patients without residual coarctation, we prospectively compared aortic stiffness by applanation tonometry and cardiac magnetic resonance; endothelial function by endothelial pulse amplitude testing; blood pressure ( BP ) phenotype by office BP , ambulatory BP monitoring, and BP response to exercise; left ventricular mass by cardiac magnetic resonance; and blood biomarkers of endothelial function, inflammation, vascular wall function, and extracellular matrix. Participants included 75 patients treated with surgery (n=28), BD (n=23), or stent (n=24). Groups had similar age at enrollment, coarctation of the aorta severity, residual gradient, and metabolic profile, but differed by age at treatment. Prevalence of systemic hypertension, aortic stiffness, endothelial function, and left ventricular mass were similar among treatment groups. However, BD patients had more‐distensible ascending aortas, lower peak systolic BP during exercise, less impairment in diurnal BP variation, and lower inflammatory biomarkers. Results were unchanged after adjustment for potential confounders, including age at treatment. Conclusions In our cohort of patients without residual coarctation, treatment modality was not associated with major vascular outcomes, even though there were some favorable vascular characteristics in the BD patients. Although this suggests that choice of treatment modality should continue to be driven by likelihood of achieving a good anatomical result, more long‐term studies are required to assess the clinical significance of the more‐optimal results of secondary markers of vascular function in BD patients. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 03262753.

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Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study

Cited by 3 publications

References 60 publications

Diagnosis and Surgical Repair for Coarctation of the Aorta With Intracardiac Defects: A Single Center Experience Based on 93 Infants

Diagnosis and Surgical Repair for Coarctation of the Aorta With Intracardiac Defects: A Single Center Experience Based on 93 Infants

Prediction of post-stenting biomechanics in coarcted aortas: A pilot finite element study

Impact of Treatment Modality on Vascular Function in Coarctation of the Aorta: The LOVE‐COARCT Study

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