Stent Implantation for Coarctation of the Aorta in Children &lt;30 kg

Mohan, Uthara R.; Danon, Saar; Levi, Daniel S.; Connolly, Dana; Moore, John W.

doi:10.1016/j.jcin.2009.07.002

Cited by 53 publications

(30 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the older child, adolescent and adult, primary stent therapy is advised both for native aortic coarctation and post-surgical recoarctation. Because of issues related to growth and the need for large sheaths for implantation, most cardiologists limit stent usage to adolescents and adults, although some workers [15,105,[111][112][113][114] advocate stents in infants and young children. We do not advocate routine use of stents in neonates, infants and young children [106,115].…”

Section: Indicationsmentioning

confidence: 99%

Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

View full text Add to dashboard Cite

To address elastic recoil of vessel wall and intimal dissection that can follow balloon angioplasty, stents have been designed and these appear to produce more effective relief of obstruction. Of the two types of stents, namely, balloon expandable and self expandable, balloon expandable stents are most commonly used in children. The usefulness of stents in the management of vascular obstructive lesions not amenable to balloon angioplasty is well established and has been successfully used to treat branch pulmonary artery stenosis, coarctation of the aorta, stenotic right ventricular outflow tract conduits, obstructive lesions of the systemic and pulmonary veins and others. The techniques of implantation, indications, immediate and follow-up results and complications were reviewed. The stents have also been effectively used in keeping open naturally occurring or artificially created inter-circulatory connections and as adjuncts in hybrid procedures, but these have not been discussed in this review. Future directions include investigative work on biodegradable stents and growth stents to address issues related to increase in vessel size in infants and children, use of drug eluding stents to prevent neo-intimal proliferation to avoid pulmonary vein restenosis and refinement of stent technology in hybrid procedures such as neonatal palliation of hypoplastic left heart syndrome and transcatheter completion of Fontan procedure. The feasibility, safety and effectiveness stents in the pediatric population are demonstrated, although scrutiny of results of larger experience with longer follow-up is important.

show abstract

Section: Indicationsmentioning

confidence: 99%

Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

View full text Add to dashboard Cite

show abstract

“…(21,32,33) In younger and smaller patients, complications mostly consist of vascular compromise, haemorrhage and dysrhythmias. Later complications include intrastent proliferation, restenosis and occlusion (3-36%).…”

Section: Discussionmentioning

confidence: 99%

“…Disadvantages of early stenting in small patients consist of: vascular compromise and an increased rate of developing instent stenosis due to the use of smaller diameter stents (the incidence of abrupt stent thrombosis is uncertain). (25,32) However, the purpose of implanting stents in this subgroup of patients is not to avoid, but only to delay surgery until either clinical condition improves (days) or somatic growth allows lower risk surgery (weeks to months). We consider the team approach and joint decision-making process with our surgeons not only extremely helpful and beneficial, but essential.…”

Section: Discussionmentioning

confidence: 99%

The use of small stents to delay surgical intervention in very young children with critical congenital heart disease

Greig

Buys

Brown

et al. 2017

SAHJ

View full text Add to dashboard Cite

“…Additionally, neonates often have transverse arch hypoplasia, which does not easily lend itself to endovascular stent placement. Some small, single center studies have had positive shortterm results with endovascular stent placement in young children, but further followup and investigation is needed [71,72] . Covered endovascular stents represent the latest transcatheter innovation and were first used for the treatment of coarctation in 1999.…”

Section: Patient Follow-upmentioning

confidence: 99%

Coarctation of the aorta: Management from infancy to adulthood

Török

Campbell

Fleming

et al. 2015

WJC

233

151

View full text Add to dashboard Cite

Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

show abstract

Stent Implantation for Coarctation of the Aorta in Children <30 kg

Abstract: As in larger patients, use of large stents for treatment of CoA in small children is effective and safe in the short term. In these patients, stent redilations will be required, and follow-up is ongoing.

Cited by 53 publications

References 25 publications

Transcatheter Stent Therapy in Children: An Update

Transcatheter Stent Therapy in Children: An Update

The use of small stents to delay surgical intervention in very young children with critical congenital heart disease

Coarctation of the aorta: Management from infancy to adulthood

Contact Info

Product

Resources

About