European Heart Journal Advance Access originally published online on September 26, 2005
European Heart Journal 2005 26(24):2728-2732; doi:10.1093/eurheartj/ehi491
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Results and mid–long-term follow-up of stent implantation for native and recurrent coarctation of the aorta
1Pediatric Cardiology Department and Adult with Congenital Heart Disease, GUCH Unit, Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se, Milan, Italy
2University Cardiology Department, Policlinico di Milano, Italy
3National Research Council, Southern Italy, c/o ISBEM, Cittadella della Ricerca, Brindisi, Italy
Received 17 June 2005; revised 18 August 2005; accepted 25 August 2005; online publish-ahead-of-print 26 September 2005.
* Corresponding author. Tel: +39 02 5277 4328; fax: +39 02 5277 4459. E-mail address: massichessa{at}yahoo.it
Aims Since the late 1980s, endovascular stents have been used in the treatment of several vascular lesions. In the last decades, stent implantation has been proposed as a reliable option for the treatment of coarctation of the aorta. In this setting, it seems to have some advantages, rendering it superior to angioplasty alone.
Methods and results Between December 1997 and December 2004, 71 consecutive patients (44 males and 27 females) underwent cardiac catheterization for native or recurrent coarctation of the aorta. Seventy-four stents were implanted. All discharged patients were enrolled in a follow-up programme. Every patient underwent clinical evaluation, echo-colour Doppler studies, and exercise ECG at 1 and 6 months after the stent implantation. Peak systolic gradient dropped from 39.3±15.3 to 3.6±5.5 mmHg (P=0.0041). The diameter of the coarcted segment increased from 8.3±2.9 to 16.4±3.8 mm (P=0.037). In our series, one death occurred in a 22-year-old girl with a recurrent coarctation of the aorta, just after stent implantation. The rate of minor complications was <2%. Re-dilatation of a previously implanted stent was performed in three patients.
Conclusion In our experience (the largest reported to the best of our knowledge), stenting of a coarctation/re-coarctation of the aorta represents a safe alternative treatment without a significant mid–long-term complication.
Key Words: Aortic coarctation • Stent • Adult with congenital heart defect
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