Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 1;1(5):100393.
doi: 10.1016/j.jscai.2022.100393. eCollection 2022 Sep-Oct.

Procedural Characteristics and Outcomes of Transcatheter Interventions for Aortic Coarctation: A Report From the IMPACT Registry

Ada C Stefanescu Schmidt  1 , Aimee Armstrong  2 , Kevin F Kennedy  3 , Ignacio Inglessis-Azuaje  1 , Eric M Horlick  4 , Ralf J Holzer  5 , Ami B Bhatt  1
Affiliations

Procedural Characteristics and Outcomes of Transcatheter Interventions for Aortic Coarctation: A Report From the IMPACT Registry

Ada C Stefanescu Schmidt et al. J Soc Cardiovasc Angiogr Interv. .

Abstract

Background: Although surgical repair was the traditional first-line treatment for native coarctation of the aorta (CoA), balloon angioplasty (BA) and stenting are now increasingly being performed. We aimed to determine the practice patterns and acute outcomes of transcatheter interventions for native coarctation in the largest multicenter registry for congenital catheterization.

Methods: CoA interventions from the IMPACT (IMproving Pediatric and Adult Congenital Treatment) National Cardiovascular Data Registry were analyzed. The procedure choice and acute outcomes were compared among patients with no prior interventions on the aortic isthmus (native CoA). Procedural success was defined as no major adverse events (MAEs) and a final peak gradient of <20 mm Hg and optimal outcome as no MAEs and a final gradient of <10 mm Hg.

Results: Over the 8-year study period, 5928 CoA procedures were performed, of which 1187 were performed in patients with native CoA. In this group, stenting was performed in more then half of children aged >1 year and >90% of those aged >8 years. Procedural success was achieved in >90% of stenting procedures but in only 69% of BAs. Stent implantation was associated with a higher likelihood of optimal gradient (<10 mm Hg) after adjustment for age and baseline characteristics. MAEs were most common in children aged <1 year (14%), occurred in 2% to 2.5% of those aged 1 to 18 years and in 6.6% of adults (P < .001), and were more likely after BA than after stenting (odds ratio, 0.5; 95% CI, 0.28-0.9; unadjusted P = .02).

Conclusions: Catheter interventions for native coarctation are performed safely in older children and adults, with a high degree of immediate procedural success, particularly with stenting.

Keywords: adult congenital heart disease; aortic coarctation; balloon angioplasty; neonatal interventions; stenting.

PubMed Disclaimer

Figures

None
Graphical abstract
Central Illustration
Central Illustration
Procedure type by age in patients with native coarctation. The combined optimal outcomes were procedural success, a final coarctation gradient of <10 mm Hg, and no major adverse events (MAEs).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Pickard S.S., Gauvreau K., Gurvitz M., et al. A national population-based study of adults with coronary artery disease and coarctation of the aorta. Am J Cardiol. 2018;122(12):2120–2124. doi: 10.1016/j.amjcard.2018.08.051. - DOI - PMC - PubMed
    1. Krishnamurthy Y., Schmidt A.C., Bittner D.O., et al. Subclinical burden of coronary artery calcium in patients with coarctation of the aorta. Am J Cardiol. 2019;123(2):323–328. doi: 10.1016/j.amjcard.2018.10.017. - DOI - PubMed
    1. Lee M.G., Babu-Narayan S.V., Kempny A., et al. Long-term mortality and cardiovascular burden for adult survivors of coarctation of the aorta. Heart. 2019;105(15):1190–1196. doi: 10.1136/heartjnl-2018-314257. - DOI - PubMed
    1. Sandoval J.P., Kang S.L., Lee K.J., Benson L., Asoh K., Chaturvedi R.R. Balloon angioplasty for native aortic coarctation in 3- to 12-month-old infants. Circ Cardiovasc Interv. 2020;13(11) doi: 10.1161/circinterventions.120.008938. - DOI - PubMed
    1. Martins J.D., Zachariah J., Selamet Tierney E.S., et al. Impact of treatment modality on vascular function in coarctation of the aorta: the LOVE-COARCT study. J Am Heart Assoc. 2019;8(7) doi: 10.1161/JAHA.118.011536. - DOI - PMC - PubMed