Self-expanding and balloon expandable covered stents in the treatment of aortic coarctation with or without aneurysm formation

D Kenny, R Margey, MS Turner, AJP Tometzki, KP Walsh, RP Martin

Research output: Contribution to journalArticle (Academic Journal)peer-review

57 Citations (Scopus)

Abstract

OBJECTIVES: We describe our complete experience with covered stent implantation for aortic coarctation including short- to medium-term outcomes. Background: Coarctation of the aorta is a heterogeneous disease process with multiple associated complications both with and without treatment. Covered stents have evolved to provide greater support to the aortic wall and a varied approach with choice of stent tailored to the anatomy of the patient is required. METHODS: We retrospectively analyzed consecutive patient data from two congenital heart centers from March 2003 to October 2007. RESULTS: We implanted 38 covered stents in 37 patients (20 female) of which three were self-expanding stents. Median age was 29.6 years (9-65) with median weight of 71.5 kg (35-95). The indications for stent placement were native coarctation (n = 13); recurrent coarctation following surgical treatment (n = 11); aneurysm associated with previous coarctation surgery (n = 7); aorto-bronchial fistula leading to acute hemoptysis (n = 2); stent fracture (n = 1); associated arterial duct (n = 2). One patient had a combination of acquired coarctation and false aneurysm. The median screening time was 10 min (3-22). The median systolic gradient of 26 mm Hg (10-60) was reduced to 4 mm Hg (0-20) postprocedure (P <0.001). There were no deaths on median follow up of 11.5 months (1-56). One patient developed aortic rupture during the procedure and required emergency surgery. CONCLUSION: Covered stent implantation for treatment of aortic coarctation is safe and highly effective in selected patients. Self-expanding stent grafts may be preferable to balloon expandable stents when there is aneurysm formation in the setting of aortopathy.
Translated title of the contributionSelf-expanding and balloon expandable covered stents in the treatment of aortic coarctation with or without aneurysm formation
Original languageEnglish
Pages (from-to)65 - 71
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume72(1)
DOIs
Publication statusPublished - Jul 2008

Bibliographical note

Publisher: Wiley

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