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Balloon Expandable Stent Implantation for Native and Recurrent Coarctation of the Aorta – Prospective Computerised Tomography Assessment of Stent Integrity, Aneurysm Formation and Stenosis Relief.
  1. Santabhanu Chakrabarti (chakrabartiss{at}yahoo.co.uk)
  1. Bristol Congenital Heart Centre, United Kingdom
    1. Damien Kenny (damien.kenny{at}ubht.nhs.uk)
    1. Bristol Congenital Heart Centre, United Kingdom
      1. Gareth J Morgan (gareth.morgan{at}ubht.nhs.uk)
      1. Bristol Congenital Heart Centre, United Kingdom
        1. Stephanie Curtis (stephanie.curtis{at}ubht.nhs.uk)
        1. Bristol Congenital Heart Centre, United Kingdom
          1. Mark C K Hamilton (mark.hamilton{at}ubht.nhs.uk)
          1. Bristol Royal Infirmary, United Kingdom
            1. Peter Wilde (peter.wilde{at}ubht.nhs.uk)
            1. Bristol Royal Infirmary, United Kingdom
              1. Andrew JP Tometzki (andrew.tometzki{at}ubht.nhs.uk)
              1. Bristol Congenital Heart Centre, United Kingdom
                1. Mark S Turner (mark.turner{at}ubht.nhs.uk)
                1. Bristol Congenital Heart Centre, United Kingdom
                  1. Robin P Martin (rob.martin{at}uhbristol.nhs.uk)
                  1. Bristol Congenital Heart Centre, United Kingdom

                    Abstract

                    Objectives: We report comprehensive clinical, echocardiographic and prospective computerised tomography (CT) follow-up data following stenting for aortic coarctation from a single centre.

                    Background: Stenting for aortic coarctation is known to be effective in the medium term. Aneurysm formation following stent implantation is a recognized complication. However, data regarding aortic wall injury and stent integrity following stent placement are sparse.

                    Methods: Full data analysis of all patients undergoing balloon expandable stent implantation and follow up procedures in a single tertiary congenital cardiac unit.

                    Results: Between October 2002 and April 2008, we performed 102 coarctation stent procedures ( 94 stents, 88 patients) . Median age was 20.6 years (range 8.5-65) and median weight 65Kgs (range 34-101). Twelve procedures were re-dilatations. Stenting resulted in reduction of coarctation gradient from a median of 20 to 4mm Hg. There were no procedure related deaths. Four patients had immediate complications During median follow-up of 34.5 months (range 4.2-72.8), 2 patients had late complications requiring additional stent procedures. Follow-up CT data are available in 84 patients with MRI in one patient (96.5%). Only 1 patient developed a procedure related aortic aneurysm. All stent fractures (n=7) occurred with a single stent design.

                    Conclusions: Stenting for aortic coarctation and recoarctation is effective with low immediate complication rates. Computerized tomography is useful in the longer term for assessment of stent integrity and post-procedural aneurysm formation. Overall incidence of post-procedural aneurysm is rare and stent fractures were not seen with newer generation stents.

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