Heart 1999;82:600-606 ( November )

Stent implantation for aortic coarctation and recoarctation

A G Magee^a, G Brzezinska-Rajszys^b, S A Qureshi^a, E Rosenthal^a, M Zubrzycka^b, J Ksiazyk^b, M Tynan^a

^a Department of Paediatric Cardiology, Guy's Hospital, 11th Floor Guy's Tower, St Thomas St, London SE1 9RT, UK, ^b Children's Memorial Hospital, Warsaw, Poland

Correspondence to: Dr Qureshi.

Accepted for publication 20 May 1999

OBJECTIVETo determine the early results of balloon expandable stent implantation for aortic coarctation or recoarctation.
DESIGNProspective observational study.
SETTINGTwo paediatric cardiology tertiary referral centres.
PATIENTS17 patients, median age 17 years (range 4.4 to 45) and median weight 61 kg (17 to 92). Six had native aortic coarctation and 11 had aortic recoarctation; 14 had upper limb systolic hypertension. Of those with recoarctation, eight had had at least one previous balloon dilatation attempt and two of these patients also had further surgical interventions.
INTERVENTIONBalloon expandable Palmaz iliac stent implantation.
MAIN OUTCOME MEASURESSystolic pressures gradients, minimum aortic diameter, upper limb blood pressures, and incidence of aneurysm formation.
RESULTS18 stents were implanted during 18 procedures in the 17 patients. Mean peak systolic pressure gradient fell from 26 mm Hg (95% confidence interval (CI), 21 to 31 mm Hg) before to 5 mm Hg (2 to 8 mm Hg) after stent implantation (p < 0.001), and mean minimum aortic diameter increased from 7 mm (95% CI, 6 to 8 mm) before to 11.3 mm (10 to 12.6 mm) after implantation (p < 0.001). Complications occurred in five patients (bleeding in two, stent migration in two, and aneurysm formation in one). Two patients remained borderline hypertensive and eight were receiving antihypertensive treatment at most recent assessment.
CONCLUSIONSStent implantation for aortic recoarctation and native coarctation gives good immediate results. Careful follow up is necessary to evaluate complications and the long term effect on blood pressure.


Keywords: coarctation; aortic recoarctation; stents

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© 1999 by Heart
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