Patch aortoplasty for coarctation of aorta: Technical considerations

Srougi, Victor

doi:10.1016/s0003-4975(95)81050-1

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…The first surgery was performed in 1944 by Drs. Crawford and Nylin, with refinement of surgical technique being accomplished over the past 4 decades (1,2). The transcatheter approach to this lesion was first performed using balloon angioplasty (BA) in the 1980s (3), with intravascular stent treatment gaining wider acceptance in the 1990s (4).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Surgical, Stent, and Balloon Angioplasty Treatment of Native Coarctation of the Aorta

Forbes

Kim

et al. 2011

Journal of the American College of Cardiology

292

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Stent patients had significantly lower acute complications compared with surgery patients or BA patients, although they were more likely to require a planned reintervention. At short-term and intermediate follow-up, stent and surgical patients achieved superior hemodynamic and integrated aortic arch imaging outcomes compared with BA patients. Because of the nonrandomized nature of this study, these results should be interpreted with caution.

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Section: Discussionmentioning

confidence: 99%

Comparison of Surgical, Stent, and Balloon Angioplasty Treatment of Native Coarctation of the Aorta

Forbes

Kim

et al. 2011

Journal of the American College of Cardiology

292

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“…In 1944, the surgical correction of CoA was performed for the first time by Crafoord in Sweden ( 3 ). In the subsequent 40 years, there have been significant improvements in the surgical technology, and the cure rate of CoA has increased significantly ( 4 ). Balloon angioplasty was conducted in 1982.…”

Section: Introductionmentioning

confidence: 99%

Follow-up of hypertension after aortic coarctation stent implantation based on safe and effective re-intervention: a retrospective cohort study

Zhang¹,

Schneider²,

Zartner³

2022

J Thorac Dis

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Background: Stent implantation for aortic coarctation (CoA) is associated with anatomical and hemodynamic advantages. Although the anatomy is corrected after the intervention, patients often still suffer from hypertension during the follow-up. Its risk factors remain unclear. There are only a few studies on the long-term follow-up of hypertension after stenting. This study aimed to investigate the factors influencing systemic hypertension after CoA by transcatheter stent placement.Methods: A total of 82 patients (native CoA: 37; men: 53) who underwent stent implantation for CoA at a median age of 123 months (range, 40 days-44 years) between January 2004 and September 2012 were included in this study. Patients with native or recurrent CoA after surgery, simple CoA or complex CoA associated with other cardiac anomalies were recruited in this study. Only stents that were expandable to adult size were implanted. After the initial stent implantation, the patients were followed up for 76.7 months (range, 6-151 months). Those who met the indications for a re-intervention underwent a balloon dilatation or stent implantation to relieve restenosis and alleviate the hypertension caused by restenosis. Patients with hypertension were treated with anti-hypertensive agents.Results: In the initial intervention, 87 stents were implanted in 82 patients. Seventy-two patients (87.8%) were diagnosed with hypertension before treatment, but only 23 (28.0%) patients had hypertension at the last follow-up, which is a number significantly lower than that before the intervention (P<0.001). Cox regression analysis showed that age at stent implantation was significantly correlated with the incidence of hypertension, which indicates that the younger the patient receiving the intervention, the lower the incidence of hypertension. Moreover, the incidence of hypertension in follow-up is related to the diagnosis. It was higher in the patients with simple CoA than those with complex CoA. There was no significant correlation between native CoA and recurrent CoA. Conclusions:The incidence of hypertension after CoA stent implantation was significantly lower than that before the intervention. Age at stent implantation is an essential influencing factor for paradoxical hypertension after CoA stent implantation. Complex CoA in patients was related to a significantly lower prevalence of follow-up hypertension.

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“…Despite considerably low prevalence of 0.34 per 1000 live births [4], a growing number of adult patients after successful correction of CoAo triggers the need for meticulous follow-up programme [5]. Notwithstanding the relatively early introduction of effective CoAo surgical treatment in 1944 [6] and a further successful implementation of transcatheter approach in 1982 [7], longterm outcome is still compromised on account of the process of arterial remodeling in pre-stenotic vascular bed, associated with arterial stiffness [8][9][10][11] and baroreceptor dysfunction [12]. The resultant markedly increased prevalence of arterial hypertension of 30-50%, regarded as a hallmark of CoAo [13][14], leads to diffuse atherosclerosis [11,[15][16][17] and notably reduced life expectancy [18][19].…”

Section: Introductionmentioning

confidence: 99%

Growth differentiation factor 15 and arterial remodeling in adult patients after succesful repair of aortic coarctation (RCD code: IV-5.A.1)

Mizia‐Stec

Wybraniec

Trojnarska

et al. 2013

Journal of Rare Cardiovascular Diseases

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Background: Coarctation of aorta (CoAo) is a congenital heart anomaly associated with high cardiovascular morbidity and mortality attributable to vascular remodeling in adult survivors following surgical management of aortic stenosis. This study sought to adjudicate the significance of novel stress-responsive biomarker, growth differentiation factor 15 (GDF-15), as an indicator of vascular remodeling and its correlation with numerous laboratory and vascular parameters in patients after successful CoAo repair. Methods and results:This research is a case-control study comprising 33 consecutive patients (19 men, 57.58%; mean age 33.9 ±9.3 years; mean age at surgery: 9.1 ±7 years; mean follow-up duration 24.8 ±6.8 years) admitted to outpatient clinic for routine follow-up after repair of CoAo (mainly Dacron patch technique) and matched with 20 healthy controls (10 men, 50%; mean age 34.8 ±9.9 years). Laboratory (GDF-15, high-sensitivity C-reactive protein) and vascular parameters (intima-media thickness, flow-and nitrate-mediated dilation, pulse-wave velocity, central arterial pressure) were assessed. Significant aortic residual gradient was present in 24 (72.7%). The circulating GDF-15 level was lower in CoAo survivors than in control group (539.56 vs. 744.98 pg/ml respectively; p < 0.001). GDF-15 concentration <550 pg/ml successfully differentiated patients after CoA repair (odds ratio [OR] = 9.2; 95%CI: 2.45-34.56, p = 0.0005). There was no difference in GDF-15 level depending on the presence of significant residual gradient (p = 0.19). No significant correlation between GDF-15 and other variables was observed. Conclusions: Low concentration of GDF-15 is characteristic of asymptomatic patients following CoAo repair, however, its clinical significance and relationship with vascular remodeling substantiates further investigation. JRCD 2013; 1 (2): 41-48

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Patch aortoplasty for coarctation of aorta: Technical considerations

Cited by 7 publications

References 4 publications

Comparison of Surgical, Stent, and Balloon Angioplasty Treatment of Native Coarctation of the Aorta

Comparison of Surgical, Stent, and Balloon Angioplasty Treatment of Native Coarctation of the Aorta

Follow-up of hypertension after aortic coarctation stent implantation based on safe and effective re-intervention: a retrospective cohort study

Growth differentiation factor 15 and arterial remodeling in adult patients after succesful repair of aortic coarctation (RCD code: IV-5.A.1)

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