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. 2016:2016:4818307.
doi: 10.1155/2016/4818307. Epub 2016 Jan 27.

Early and Long-Term Results of Stent Implantation for Aortic Coarctation in Pediatric Patients Compared to Adolescents: A Single Center Experience

Sara Bondanza  1 , Maria Grazia Calevo  2 , Maurizio Marasini  1
Affiliations

Early and Long-Term Results of Stent Implantation for Aortic Coarctation in Pediatric Patients Compared to Adolescents: A Single Center Experience

Sara Bondanza et al. Cardiol Res Pract. 2016.

Abstract

Background. Stents have become the treatment of choice for native aortic coarctation in adults and adolescents, but in pediatric patients insufficient data are currently available to identify the best therapeutic option. Methods. To compare the outcomes of pediatric and adolescent patients, we retrospectively evaluated early and long-term results of stenting for aortic coarctation in 34 patients divided into 2 groups (A and B) composed, respectively, of 17 children (mean age 8.2 ± 2.3, weight ≤30 kg) and 17 adolescents (mean age 14.3 ± 1.7, weight >30 kg). Results. No significant differences in outcome were found between groups immediately after the procedure. In all of our patients, peak systolic gradient pressure significantly decreased after stenting from 43.7 ± 12 to 1.7 ± 3.1 mmHg in group A and from 39.4 ± 16.8 to 1.6 ± 3 in group B (p < 0.0001). We observed early and late adverse events in both groups: early femoral vessel injury or thrombosis was more frequent in younger patients, as well as restenosis due to vessel growth requiring stent redilatations, often complicated by stent fractures. Data from long-term follow-up showed that, in younger patients, stress-related hypertension was more frequent. Conclusions. The procedure was immediately safe and effective in both groups. Pediatric patients must be accurately selected before stenting because they could probably need reinterventions and stents could impact on their future therapeutic perspectives.

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Figures

Figure 1
Figure 1
Anteroposterior view: severe aortic coarctation.
Figure 2
Figure 2
30° left anterior oblique view: stent positioning across the stenosis.
Figure 3
Figure 3
30° left anterior oblique view: stent successfully deployed.
Figure 4
Figure 4
Lateral view: growth-induced narrowing of the previously implanted stent.
Figure 5
Figure 5
Lateral view: shortening and fracture of the stent after redilatation.
See this image and copyright information in PMC

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