Register for email alerts and news feeds:
This journal | BMJ Group
rss
Heart 1999;81:166-170; doi:10.1136/hrt.81.2.166
Copyright © 1999 BMJ Publishing Group Ltd & British Cardiovascular Society

Heart 1999;81:166-170 ( February )

Middle aortic syndrome treated by stent implantation

G Brzezinska-Rajszys,a S A Qureshi,b J Ksiazyk,a M Zubrzycka,a A Kosciesza,a K Kubicka,a M Tynanb

a Catheterisation Laboratory, Children's Memorial Health Institute, Al Dzieci Polskich 20, 04-736 Warsaw-Miedzylesie, Poland, b Department of Paediatric Cardiology, Guy's Hospital, London SE1, UK

Correspondence to: Dr Brzezinska-Rajszys.

Accepted for publication 6 October 1998

Objectives---To determine outcome of stent implantation in patients with middle aortic syndrome.
Design---Prospective study, case series.
Setting---A tertiary paediatric cardiology centre in a children's hospital.
Patients---Five patients, aged 4 to 17 years (mean 11.4 years), with upper limb hypertension due to middle aortic syndrome.
Intervention---Stents were implanted in the mid/lower thoracic/upper abdominal aorta.
Main outcome measure---Satisfactory deployment of stents and blood pressure control.
Results---In all patients, angiocardiography showed long segment stenosis in the mid or lower thoracic/upper abdominal aorta. The pressure gradient was between 40 and 90  mm Hg (mean 63.2  mm Hg). Seven Palmaz stents were implanted. Immediately after implantation, the gradient decreased to between 0 and 35  mm Hg (mean 13.6  mm Hg). Angiography showed a satisfactory result with widely patent stents in all. In one patient, thrombosis of the stent occurred six days after implantation. This was successfully treated with infusion of alteplase, further balloon dilatation, and implantation of a second stent overlapping the first, both dilated to 10 mm diameter. One patient had elective redilatation of the stent six months after implantation, with further reduction of the gradient from 35  mm Hg to 10  mm Hg. At the latest follow up between three and 20 months (mean 12.2 months) after stent implantation, in four patients blood pressure was better controlled with antihypertensive drugs. One patient was normotensive without drugs. Computed tomography showed no aneurysm formation in the region of the stents.
Conclusions---Stent implantation is a preferable alternative to surgery in the treatment of patients with middle aortic syndrome and merits further evaluation.

Keywords: middle aortic syndrome; stent implantation; paediatric cardiology; interventional cardiology

© 1999 by Heart
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • Zeltser, I., Parness, I. A., Ko, H., Holzman, I. R., Kamenir, S. A. (2003). Midaortic Syndrome in the Fetus and Premature Newborn: A New Etiology of Nonimmune Hydrops Fetalis and Reversible Fetal Cardiomyopathy. Pediatrics 111: 1437-1442 [Abstract] [Full Text]  
  • Segers, B., Derluyn, M., Barroy, J.-P., Brunet, A. P. (2001). Isolated supradiaphragmatic descending thoracic aorta stenosis in a Takayasu's disease: surgical cure. Eur. J. Cardiothorac. Surg. 20: 1243-1245 [Abstract] [Full Text]  
  • Eliason, J. L., Passman, M. A., Guzman, R. J., Naslund, T. C. (2001). Durability of Percutaneous Angioplasty and Stent Implantation for the Treatment of Abdominal Aortic Coarctation: A Case Report. VASC ENDOVASCULAR SURG 35: 397-401 [Abstract]  
  • JAIN, A K, BALI, H K (1999). Stenting for middle aortic syndrome. Heart 82: 534e-534 [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Show me all >>