Reoperation for recurrent aortic coarctation

Ralph-Edwards, Anthony; Williams, William G.; Coles, John C.; Rebeyka, Ivan M.; Trusler, George A.; Freedom, Robert M.

doi:10.1016/0003-4975(95)00619-v

Cited by 46 publications

(44 citation statements)

References 10 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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“…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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“…The incidence of spinal cord ischemia related to surgical repair of coarctation of the aorta ranges from 0% [9] to 0.4% [10]. Cases of spontaneous cord infarction associated with coarctation of the aorta have also been reported [11].…”

Section: Discussionmentioning

confidence: 98%