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European Heart Journal Advance Access published online on September 26, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi491
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received June 17, 2005
Revised August 18, 2005
Accepted August 25, 2005

Clinical research

Results and mid-long-term follow-up of stent implantation for native and recurrent coarctation of the aorta

Massimo Chessa 1*, Marianna Carrozza 1, Gianfranco Butera 1, Luciane Piazza 1, Diana Gabriela Negura 1, Claudio Bussadori 2, Edoardo Bossone 3, Alessandro Giamberti 1, and Mario Carminati 1

1 Pediatric Cardiology Department and Adult with Congenital Heart Disease, GUCH Unit, Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se, Milan, Italy
2 University Cardiology Department, Policlinico di Milano, Italy
3 National Research Council, Southern Italy, c/o ISBEM, Cittadella della Ricerca, Brindisi, Italy

* To whom correspondence should be addressed.
Massimo Chessa, E-mail: massichessa{at}yahoo.it


  Abstract

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.

Keywords: Aortic coarctation; Stent; Adult with congenital heart defect.
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