Stenting aortic coarctation in children: Immediate and midterm results

• Main Authors: Kuburović Vladimir, Prijić Sergej, Rakić Sanja, Vukomanović Vladislav, Košutić Jovan
• Format: Article
• Language: English
• Published: Serbian Medical Society 2011-01-01
• Series: Srpski Arhiv za Celokupno Lekarstvo
• Subjects: stent; aortic coarctation; children
• Online Access: http://www.doiserbia.nb.rs/img/doi/0370-8179/2011/0370-81791112728K.pdf

Introduction. Stent implantation, in patients with different forms of aortic coarctation, has significant theoretical advantages over primary balloon dilatation (BD). It can achieve overdilatation of the coarcted segment with the rigid endoprothesis maintaining the increase in vessel diameter regardless of the intimal injury and, thus, reducing the likelihood of restenosis. Moreover, by preventing vascular recoil, stents can successfully expand long-segment tubular coarctations, hypoplastic isthmus and hypoplastic transverse aortic arch. Finally, by facilitating good apposition of the torn intima to the aortic wall, they can significantly reduce the incidence of aneurysm formation. Objective. Evaluation of the immediate and mid-term results of stent implantation in patients with different forms of aortic coarctation. Methods. Between February 2005 and March 2010 eleven stents were implanted in nine patients (two female and seven male) either with post surgical or post primary BD residual coarctation/recoarctation or with native aortic coarcatation. Mean age of our patients was 14±3 years (9.4-18.1 years) and mean body weight 54±18 kg (29-76 kg). Results. Pressure gradient across the coarctation site was reduced from 24.9±12.4 mm Hg before to 3.9±5.0 mm Hg after stenting (p=0.000). There were no complications. Mean followup was 2.0±1.5 years (range 0.1-5.2 years). In patients with localised aortic arch narrowing no restenosis or aneurysm formation was observed (residual pressure gradient 0-5 mm Hg). Conclusion. In properly selected children (body weight >25 kg), adolescents and young adults stenting is the method of choice for patients with various forms of aortic arch obstruction.