Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T20:39:56.788Z Has data issue: false hasContentIssue false
  • English
  • Français

Cheatham platinum stent implantation in children with coarctation of the aorta: single-centre short-term, intermediate-term, and long-term results from Turkey

Published online by Cambridge University Press:  23 July 2013

Ali Baykan ,
Nazmi Narin ,
Abdullah Ozyurt ,
Mustafa Argun ,
Ozge Pamukcu ,
Ertugrul Mavili ,
Saadettin Sezer ,
Sertac H. Onan  and
Kazım Uzum
Ali Baykan
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Nazmi Narin
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Abdullah Ozyurt*
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Mustafa Argun
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ozge Pamukcu
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ertugrul Mavili
Affiliation:
Department of Paediatric Radiology, Erciyes University Medical Faculty, Kayseri, Turkey
Saadettin Sezer
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Sertac H. Onan
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Kazım Uzum
Affiliation:
Department of Paediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
*
Correspondance to: A. Ozyurt, Department of Peadiatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey. Tel: +090 505 745 6621; Fax: +090 352 437 5825; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Our aim was to evaluate patients who were treated by percutaneous stent implantation. Methods: Patients with aortic coarctation (n = 35) who had been treated with 38 stents – 12 bare and 26 covered – were evaluated. The demographics and procedural and follow-up data were recorded from hospital registers and compared according to patient specifications, for example, weight and coarctation nature. Results: The procedure was successful in all patients. There was a statistically significant difference between the patients with native coarctation (n = 17) and those with recurrent coarctation (n = 18) in terms of pre-procedural blood pressures, systolic gradients, coarctation diameters, and the ratio of the coarctation site diameter to the descending aorta diameter. Although all patients received antihypertensive drugs before the procedure, the drug was discontinued in 26 patients during follow-up (p < 0.001). Stent migration was observed in four patients with recurrent coarctation (11.4%), and peripheral arterial injury was seen in three patients (8.5%). The mean follow-up time was 34 ± 16 months. On average, 21 (6–42) months after the procedure, six patients underwent cardiac catheterisation. At least 2 years after the procedure, tomography was performed in 20 patients (57.2%). Patients who were evaluated by multi-slice computerised tomography revealed no pathologies. There was no statistically significant difference between the five patients weighing less than 20 kg and the other 30 patients in terms of demographic and procedural characteristics, procedure success and complication rates, and follow-up data. Conclusion: Stent implantation for aortic coarctation is a method yielding satisfactory results in reducing coarctation gradients, efficient enlargement of the lesion area, and resolution of hypertension for children, including those weighing less than 20 kg.

Keywords

Cheatham platinum stentcoarctation of the aortahypertensionhypoplastic aortic archpaediatricstenting
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 4 , August 2014 , pp. 675 - 684
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Singer, MI, Rowen, M, Dorsey, TJ. Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn. Am Heart J 1982; 103: 131–132.CrossRefGoogle ScholarPubMed
2. Suarez de Lezo, J, Pan, M, Romero, M, et al. Balloon-expandable stent repair of severe coarctation of aorta. Am Heart J 1995; 129: 1002–1008.CrossRefGoogle ScholarPubMed
3. Forbes, TJ, Garekar, S, Amin, Z, et al. Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: a multi-institutional study. Catheter Cardiovasc Interv 2007; 70: 276–285.CrossRefGoogle ScholarPubMed
4. Thanopoulos, B, Triposkiadis, F, Margetakis, A, Mullins, CE. Long segment coarctation of the thoracic aorta: treatment with multiple balloon-expandable stent implantation. Am Heart J 1997; 133: 470–473.CrossRefGoogle ScholarPubMed
5. Johnston, TA, Grifka, RG, Jones, TK. Endovascular stents for the treatment of coarctation of the aorta: acute results and follow-up experience. Catheter Cardiovasc Interv 2004; 62: 499–505.CrossRefGoogle ScholarPubMed
6. Cheatham, JP. Stenting coarctation of the aorta. Catheter Cardiovasc Interv 2001; 54: 112–125.CrossRefGoogle ScholarPubMed
7. Shah, L, Hijazi, Z, Sandhu, S, Joseph, A, Cao, QL. Use of endovascular stents from the treatment of coarctation of the aorta in children and adults: intermediate and midterm results. J Invas Cardiol 2005; 11: 614–618.Google Scholar
8. Pedra, CA, Fontes, VF, Esteves, CA, et al. Stenting vs balloon angioplasty for discrete unoperated coarctation of the aorta in adolescents and adults. Catheter Cardiovasc Interv 2005; 64: 495–506.CrossRefGoogle ScholarPubMed
9. Pedra, CA, Fontes, VF, Esteves, CA, et al. Use of covered stents in the management of coarctation of the aorta. Pediatr Cardiol 2005; 26: 431–439.CrossRefGoogle ScholarPubMed
10. Erdem, A, Akdeniz, C, Sarıtaş, T, et al. Cheatham-platinum stent for native and recurrent aortic coarctation in children and adults: immediate and early follow-up results. Anadolu Kardiyol Derg 2011; 11: 441–449.Google ScholarPubMed
11. Baykan, A, Karagöz, T, Celiker, A. Endovascular stent implantation for coarctation of the aorta in children and young adults: intermediate follow-up results from Turkey. Turk J Pediatr 2009; 51: 116–119.Google Scholar
12. Holzer, R, Qureshi, S, Ghasemi, A, et al. Stenting of aortic coarctation: acute, intermediate and long-term results of a prospective multi-institutional registry Congenital Cardiovasculer Stud Consortium (CCISC). Catheter Cardiovasc Interv 2010; 76: 553–563.CrossRefGoogle Scholar
13. Krasemann, T, Bano, M, Rosenthal, E, Qureshi, SA. Results of stent implantation for native and recurrent coarctation of the aorta-follow-up of up to 13 years. Catheter Cardiovasc Interv 2011; 78: 405–412.CrossRefGoogle ScholarPubMed
14. Chessa, M, Carrozza, M, Butera, G, et al. Results and mid-long-term follow-up of stent implantation for native and recurrent coarctation of the aorta. Eur Heart J 2005; 26: 2728–2732.CrossRefGoogle ScholarPubMed
15. Sua′rez de Lezo, J, Pan, M, Romero, M, et al. Percutaneous interventions on severe coarctation of the aorta: a 21-year experience. Pediatr Cardiol 2005; 26: 176–189.CrossRefGoogle Scholar
16. Qureshi, AM, McElhinney, DB, Lock, JE, Landzberg, MJ, Lang, P, Marshall, AC. Acute and intermediate outcomes, and evaluation of injury to the aortic wall, as based on 15 years experience of implanting stents to treat aortic coarctation. Cardiol Young 2007; 17: 307–318.CrossRefGoogle Scholar
17. Forbes, TJ, Moore, P, Pedra, CA, et al. Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. Catheter Cardiovasc Interv 2007; 70: 569–577.CrossRefGoogle ScholarPubMed
18. Thanopoulos, BV, Eleftherakis, N, Tzanos, K, Skoularigis, I, Triposkiadis, F. Stent implantation for adult aortic coarctation. J Am Coll Cardiol 2008; 52: 1815–1816.CrossRefGoogle ScholarPubMed
19. Hager, A, Kanz, S, Kaemmerer, H, Schreiber, C, Hess, J. Coarctation long-term assessment (COALA): significance of arterial hypertension in a cohort of 404 patients up to 27 years after surgical repair of isolated coarctation of the aorta, even in the absence of restenosis and prosthetic material. J Thorac Cardiovasc Surg 2007; 134: 738–745.CrossRefGoogle Scholar
20. Wright, GE, Nowak, CA, Goldberg, CS, Ohye, RG, Bove, EL, Rocchini, AP. Extended resection and end-to-end anastomosis for aortic coarctation in infants: results of a tailored surgical approach. Ann Thorac Surg 2005; 80: 1453–1459.CrossRefGoogle ScholarPubMed
21. Nienaber, CA, Kische, S, Rehders, TC, et al. Rapid pacing for better placing: comparison of techniques for precise deployment of endografts in the thoracic aorta. J Endovasc Ther 2007; 14: 506–512.CrossRefGoogle ScholarPubMed
22. Moltzer, E, Roos-Hesselink, JW, Yap, SC, et al. Endovascular stenting for aortic (re)coarctation in adults. Neth Heart J 2010; 18: 430–436.CrossRefGoogle ScholarPubMed
23. Kannan, BR, Srinivasan, M. Stent migration during transcatheter management of coarctation of aorta. Catheter Cardiovasc Interv 2012; 79: 408–413.CrossRefGoogle ScholarPubMed
24. Tanous, D, Collins, N, Dehghani, P, Benson, LN, Horlick, EM. Covered stents in the management of coarctation of the aorta in the adult: initial results and 1-year angiographic and hemodynamic follow-up. Int J Cardiol 2010; 140: 287–295.CrossRefGoogle ScholarPubMed
25. Carr, JA. The results of catheter-based therapy compared with surgical repair of adult aortic coarctation. J Am Coll Cardiol 2006; 47: 1101–1107.CrossRefGoogle ScholarPubMed
26. Dryżek, P, Ostrowska, K, Góreczny, S, Moszura, T, Politowska, B, Sysa, A. Stent implantation in recoarctation of aorta in infant. Kardiol Pol 2012; 70: 60–62.Google ScholarPubMed
27. Fink, C, Peuster, M, Hausdorf, G. Endovascular stenting as an emergency treatment for neonatal coarctation. Cardiol Young 2000; 10: 644–646.CrossRefGoogle ScholarPubMed
28. Lucas, V. Stent treatment of neonatal coarctation: another option for critically ill or extremely small patients with unoperated coarctation or failed surgery. Catheter Cardiovasc Interv 2010; 75: 562.CrossRefGoogle ScholarPubMed
29. Rao, PS. Transcatheter interventions in critically ill neonates and infants with aortic coarctation. Ann Pediatr Cardiol 2009; 2: 116–119.CrossRefGoogle ScholarPubMed
30. Rao, PS. Stents in the management of aortic coarctation in young children. JACC Cardiovasc Interv 2009; 2: 884–886.CrossRefGoogle ScholarPubMed