Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T21:02:55.620Z Has data issue: false hasContentIssue false
  • English
  • Français

Endovascular treatment of aortic coarctation with a novel BeGraft aortic stent in children and young adults: a single-centre experience with short-term follow-up results

Part of: Interventional Cardiology

Published online by Cambridge University Press:  21 June 2021

Murat Muhtar Yılmazer Open the ORCID record for Murat Muhtar Yılmazer [Opens in a new window] ,
Gamze Vuran ,
Timur Meşe Open the ORCID record for Timur Meşe [Opens in a new window] ,
Barış Güven Open the ORCID record for Barış Güven [Opens in a new window] ,
Cüneyt Zihni ,
Engin Gerçeker ,
Eser Doğan ,
Mehmet Murat ,
Ceren Karahan  and
Uğur Karagöz
...Show all authors
Murat Muhtar Yılmazer*
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Gamze Vuran
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Timur Meşe
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Barış Güven
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
Cüneyt Zihni
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Engin Gerçeker
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Eser Doğan
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Mehmet Murat
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Ceren Karahan
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Uğur Karagöz
Affiliation:
Department of Pediatric Cardiac Surgery, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
Mustafa Karaçelik
Affiliation:
Department of Pediatric Cardiac Surgery, University of Health Sciences, İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
*
Author for correspondence: Murat Muhtar Yılmazer, Assoc. Prof, Department of Pediatric Cardiology, University of Health Sciences, Dr. Behçet Uz Children’s Hospital, Alsancak/Izmir, Turkey. Tel: 0090 232 4116184; Fax: 0090 232 4892315. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

We present our experience and outcomes with the BeGraft in the treatment of aortic coarctation in a predominantly paediatric population.

Methods:

This study includes a retrospective analysis of patients who had Begraft aortic stent implantation between 2018 and 2020 from a single centre.

Results:

The BeGraft aortic stent was used in 11 patients (7 males, 4 females) with a median age of 14 (13–21) years and a median weight of 65 (46–103) kg. Coarctation was native in five patients and recurrent in six patients. Median stent diameter and length were 16 mm and 38 mm, respectively. The median peak-to-peak pressure was 30 (12–55) mmHg before the procedure and 5 (0–17) mmHg after the procedure. The stenting procedure was successful in 10 of the 11 patients. Stent migration to the abdominal aorta occurred on post-procedure day 1 in the 21-year-old patient, who had previously undergone surgical closure of the ventricular septal defect and balloon angioplasty for coarctation. After repositioning failed, the stent was safely fixed in the abdominal aorta. Strut distortion also occurred during balloon retrieval in one patient, but no aneurysm or in-stent restenosis was observed at 1-year follow-up. The patients were followed for a median of 14 (4–25) months and none required redilation.

Conclusions:

Our initial results demonstrated that the BeGraft aortic stent effectively reduced the pressure gradient in selected native and recurrent cases. Despite advantages such as a smaller sheath and low profile, more experience and medium- to long-term results are needed.

Keywords

Aortic diseaseendovascular treatmentcoarctationstent graft
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 3 , March 2022 , pp. 451 - 458
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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

Fyler, DC, Buckley, LP, Hellenbrand, WE, et al. Report of the New England regional infant cardiac program. Pediatrics 1980, 65: 432–436.Google Scholar
Suradi, H, Hijazi, ZM. Current management of coarctation of the aorta. Glob Cardiol Sci Pract 2015; 2015: 44. doi: 10.5339/gcsp.2015.44.CrossRefGoogle ScholarPubMed
O’Laughlin, MP, Perry, SB, Lock, JE, Mullins, CE. Use of endovascular stents in congenital heart disease. Circulation 1991, 83: 1923–1939. doi: 10.1161/01.CIR.83.6.1923.CrossRefGoogle ScholarPubMed
Gunn, J, Cleveland, T, Gaines, P. Covered stent to treat coexistent coarctation and aneurysm of the aorta in a young man Heart 1999; 82: 351. doi: 10.1136/hrt.82.3.351.CrossRefGoogle Scholar
Forbes, T, Matisoff, D, Dysart, J, Aggarwal, S. Treatment of coexistent coarctation and aneurysm of the aorta with covered stent in a pediatric patient. Pediatr Cardiol 2003, 24: 289–291. doi: 10.1007/s00246-002-0262-9.CrossRefGoogle ScholarPubMed
Qureshi, SA, Zubrzycka, M, Brzezinska-Rajszys, G, Kosciesza, A, Ksiazyk, J. Use of covered Cheatham-Platinum stents in aortic coarctation and recoarctation. Cardiol Young 2004; 14: 50–54. doi: 10.1017/s104795110400109x.CrossRefGoogle ScholarPubMed
National Heart, Lung, and Blood Institute. Report of the task force on blood pressure control in children. Pediatrics 1977; 59: 797–798.Google Scholar
Machii, M, Becker, AE. Hypoplastic aortic arch morphology pertinent to growth after surgical correction of aortic coarctation. Ann Thorac Surg 1997; 64: 516–520. doi: 10.1016/S0003-4975(97)00444-X.CrossRefGoogle ScholarPubMed
Qureshi, SA. Use of covered stents to treat coarctation of the aorta. Korean Circ J 2009; 39: 261–263. doi: 10.4070/kcj.2009.39.7.261.CrossRefGoogle ScholarPubMed
Tzifa, A, Ewert, P, Brzezinska-Rajszys, G, et al. Covered Cheatham-platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol 2006; 47: 1457–1463.CrossRefGoogle ScholarPubMed
Golden, AB, Hellenbrand, WE. Coarctation of the aorta: stenting in children and adults Catheter Cardiovasc Interv 2007; 69: 289–289. doi: 10.1002/ccd.21009.CrossRefGoogle ScholarPubMed
Pedra, C, Peirone, AR, Costa, RN, Bruckheimer, E. Covered-stent implantation in coarctation of the aorta: indications, materials, techniques and outcomes. Interven Cardiol 2011; 3: 67–77.CrossRefGoogle Scholar
Moltzer, E, Roos-Hesselink, JW, Yap, SC, et al. Endovascular stenting for aortic (re)coarctation in adults. Neth Heart J 2010; 18: 430–436. doi: 10.1007/BF03091810.CrossRefGoogle ScholarPubMed
Chessa, M, Carrozza, M, Butera, G, et al. Results and mid-long-term follow-up of stent implantation for native recurrent coarctation of the aorta Eur Heart J 2005; 26: 2728–2732. doi: 10.1093/eurheartj/ehi491.CrossRefGoogle ScholarPubMed
Suárez 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. doi: 10.1007/s00246-004-0961-5.CrossRefGoogle ScholarPubMed
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. doi: 10.1002/ccd.21191.CrossRefGoogle ScholarPubMed
Tomita, H, Nakanishi, T, Hamaoka, K, Kobayashi, T, Ono, Y. Stenting in congenital heart disease: medium- and long-term outcomes from the JPIC stent survey. Circ J 2010; 74: 1676–1683. doi: 10.1253/circj.cj-10-0157.CrossRefGoogle ScholarPubMed
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 implantating stents to treat aortic coarctation. Cardiol Young 2007; 17: 307–318. doi: 10.1017/S1047951107000339.CrossRefGoogle Scholar
Kenny, D, Margey, M, Turner, MS, Tometzki, AJ, Walsh, KP, Martin, RP. Self-expanding and balloon expandable covered stents in the treatment of aortic coarctation with or without aneurysm formation. Catheter Cardiovasc Interv, 2008; 72: 65–71. doi: 10.1002/ccd.21559.Google ScholarPubMed
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 followup. Int J Cardiol 2010; 140: 287–295. doi: 10.1016/j.ijcard.2008.11.085.CrossRefGoogle Scholar
Collins, N, Mahadevan, V, Horlick, E. Aortic rupture following a covered stent for coarctation: delayed recognition. Catheter Cardiovasc Interv 2006; 68: 653–655. doi: 10.1002/ccd.20831.CrossRefGoogle ScholarPubMed
Pedra, C, Fontes, V, Esteves, C, et al. Use of covered stents in the management of coarctation of aorta. Pediatr Cardiol 2005; 26: 431–439. doi: 10.1007/s00246-004-0814-2.CrossRefGoogle Scholar
Promphan, W, Han Siang, K, Prachasilchai, P, et al. Feasibility and early outcomes of aortic coarctation treatments with BeGraft Aortic stent. Catheter Cardiovasc Interv 2020; 96: 310–316. doi: 10.1002/ccd.28892.CrossRefGoogle ScholarPubMed
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. doi: 10.1002/ccd.21164.CrossRefGoogle ScholarPubMed
Popovici, I, Liuba, P, Surev, A, et al. Short-term clinical follow-up of the treatment of aortic coarctation with a new generation of device. Rom J Cardiol 2018; 28: 160–167.Google Scholar
Carr, JA. The results of catheter-based therapy compared with surgical repair of adult aortic coarctation. J Am Coll Cardiol 2006; 47: 1101–1107. doi: 10.1016/j.jacc.2005.10.063.CrossRefGoogle ScholarPubMed
Al Balushi, A, Pascall, E, Jones, MI, Qureshi, S, Butera, G. Initial experience with a novel ePTFE-covered balloon expandable stent in patients with near-atretic or severe aortic coarctation and small femoral arterial access. Cardiol Young 2021; 31: 224–228. doi: 10.1017/S1047951120003728.CrossRefGoogle ScholarPubMed
Chang, ZP, Jiang, SL, Xu, ZY et al. Use of covered Cheatham-Platinum stent as the primary modality in the treatment for native coarctation of the aorta. Chin Med J 2012, 125:1005–1009.Google ScholarPubMed
Erdem, A, Akdeniz, C, Saritas, T, et al. Cheatham-Platinum stent for native and recurrent aortic coarctation in children and adults: immediate and early follow-up results. Anadolu Kardiyol Dergisi 2011, 11:441–449. doi: 10.5152/akd.2011.112.Google ScholarPubMed