Heart 2000;84:65-70 ( July )

Interventional cardiology surgery

Stent treatment for coarctation of the aorta: intermediate term follow up and technical considerations B D Thanopoulos^a, L Hadjinikolaou^b, G N Konstadopoulou^a, G S Tsaousis^a, F Triposkiadis^b, P Spirou^b

^a Department of Cardiology, Aghia Sophia Children's Hospital, Thivon and Levadias Street, Athens 115 27, Greece, ^b Departments of Cardiology and Cardiac Surgery, University Hospital of Thessalia, Larissa, Greece

Correspondence to: Dr Thanopoulos email: vasiliosthanopoulos{at}usa.net

Accepted 28 March 2000

OBJECTIVETo report the initial and intermediate term results of stent implantation in children with coarctation of the aorta.
PATIENTS AND DESIGN17 patients with coarctation of the aorta underwent stent implantation (median age 11 years, range 0.4-15 years); six were treated for isolated coarctation, nine for recurrent coarctation (five after surgical repair and four after balloon dilatation), and two for complex long segment coarctation.
INTERVENTIONSThe procedure was guided by a second catheter placed transseptally in the left ventricle or the aorta proximal to the coarctation site, for angiographic and haemodynamic monitoring during the procedure. Twenty two stents were implanted in 17 patients. One of the patients with long segment coarctation received four stents and the other three. Palmaz 4014 stents were placed in 11 patients, Palmaz 308 in five, and Palmaz 154 in one.
RESULTSImmediately after stent implantation the peak systolic gradient (mean (SD)) fell from 50.0 (24.5) to 2.1 (2.4) mm Hg (p < 0.05). The diameter of the stenotic lesion increased from 5.1 (1.5) mm to 13.9 (2.4) mm (p < 0.05). There were no deaths or procedure related complications. At a median follow up of 33 months, no cases of recoarctation were identified, either clinically (0/17; 0%, 95% confidence interval (CI) 0% to 19%) or angiographically (0/13; 0%, 95% CI 0% to 25%).
CONCLUSIONSStent implantation for the treatment of coarctation of the aorta appears to have very low morbidity and mortality, and reasonable intermediate term results. Long term freedom from recoarctation using this method remains to be determined in comparison with simple balloon dilatation.


Keywords: aortic coarctation; blood vessel prostheses; stents

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© 2000 by Heart
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