Balloon Angioplasty of Recurrent Coarctation: A 12-Year Review

Yetman, Angela T; Nykanen, David; McCrindle, Brian W.; Sunnegårdh, Jan; Adatia, Ian; Freedom, Robert M.; Benson, Lee

doi:10.1016/s0735-1097(97)00228-3

Cited by 151 publications

(108 citation statements)

References 38 publications

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“…A pressure gradient Ͼ20 mm Hg by catheterization has been proposed in numerous studies as an indication for surgical or balloon dilation of CoA and for the definition of procedural success. [1][2][3][4]6,7,27,28 The limitations inherent to relying on only one measurement of CoA severity, however, are recognized. .…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac catheterization with angiography and hemodynamic evaluation is considered the reference standard, and many published reports regard a transcatheter peak-to-peak pressure gradient Ն20 mm Hg as an important criterion for the diagnosis of hemodynamically significant CoA in the setting of normal cardiac index. [1][2][3][4][5][6][7][8] Several noninvasive methods have been used to assess the severity of CoA. Arm-to-leg blood pressure difference measured by sphygmomanometry can provide helpful information, but several reports have shown that it may not accurately represent the hemodynamic severity of the stenosis.…”

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confidence: 99%

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Magnetic Resonance Imaging Predictors of Coarctation Severity

et al. 2005

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Background-MRI is increasingly used for anatomic assessment of aortic coarctation (CoA), but its ability to predict the transcatheter pressure gradient, considered the reference standard for hemodynamic severity, has not been studied in detail. This study evaluated the ability of MRI to distinguish between mild versus moderate and severe CoA as determined by cardiac catheterization. Methods and Results-The clinical, MRI, and catheterization data of 31 subjects referred for assessment of native or recurrent CoA were reviewed retrospectively. Patients were divided into 2 groups on the basis of peak coarctation gradient by catheterization: Ͻ20 mm Hg (nϭ12) and Ն20 mm Hg (nϭ19). Patients with cardiac index Ͻ2.2 L · min

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Magnetic Resonance Imaging Predictors of Coarctation Severity

et al. 2005

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“…[7][8][9] However, relapse after coarctation repair and complications related to surgical procedures are not uncommon, with aneurysm formation, stenosis, or occlusion of bypass grafts. 10 -12 Recurrent coarctation used to be the only late complication amenable to interventional treatment in lieu of surgical graft interposition or end-to-end anastomosis [13][14][15] ; postsurgical aneurysm may quality next for interventional repair.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

et al. 2003

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Background-Formation of aortic aneurysm late after surgical repair of coarctation carries a significant risk of rupture and lethal outcome, and repeat surgery is associated with a 14% in-hospital mortality rate and morbidity from paraplegia, injury to the central nervous system, or from bleeding. The potential of nonsurgical endovascular repair by the use of stent-grafts in lieu of repeat surgery for postcoarctation aneurysm is unknown. Methods and Results-The concept of postsurgical endovascular stent-graft placement was evaluated with respect to feasibility and safety in 6 consecutive patients with late aneurysm formation after coarctation repair. All patients had aneurysm formation late after patch aortoplasty; placement of an elephant trunk during surgical repair of secondary type I dissection preceded formation of a local aneurysm in 2 cases. Patient age was 49Ϯ12 years, ranging from 31 to 68 years. Transluminal placement of customized stent-grafts was successful, with no 30-day or 1-year intervention-related mortality or morbidity. Follow-up survey of 11 to 47 months revealed optimal reconstruction of the thoracic aorta; 1 patient died 11 months after endovascular repair from cancer. Conclusions-Nonsurgical

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“…The generally accepted criterion for intervention in a biventricular heart is a peak-to-peak gradient of 20 mm Hg [3,12,30,44]. This criterion, although arbitrary by itself, has been even more inappropriately applied to univentricular hearts, despite the fact that studies have shown that peak systolic gradients \20 mm Hg can cause significant diastolic dysfunction [23,41] [37].…”

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confidence: 99%

Fontan “Ten Commandments” Revisited and Revised

Stern

2010

Pediatr Cardiol

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Choussat's ''Ten Commandments,'' which describes the components of an ideal Fontan candidate, was first published in 1977. Despite the wisdom in these commandments, it is clear from a historic perspective that total compliance with all criteria does not necessarily portend excellent long-term survival. I believe the end point of the original commandments should be modified to include improvement in long-term survival. I suggest the following single commandment: ''Thou Shalt Be Perfect.''

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Balloon Angioplasty of Recurrent Coarctation: A 12-Year Review

Abstract: Although the majority of patients undergoing percutaneous balloon angioplasty for recoarctation of the aorta will achieve long-term benefit, the need for further surgical intervention in those with transverse arch hypoplasia remains high.

Cited by 151 publications

References 38 publications

Magnetic Resonance Imaging Predictors of Coarctation Severity

Magnetic Resonance Imaging Predictors of Coarctation Severity

Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

Fontan “Ten Commandments” Revisited and Revised

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