Journal article
Acute and medium term results of balloon expandable stent placement in the transverse arch—a multicenter pediatric interventional cardiology early career society study
Catheterization and cardiovascular interventions, Vol.96(6), pp.1277-1286
11/2020
DOI: 10.1002/ccd.29248
PMID: 32902911
Abstract
Objectives and Background
Coarctation of the aorta represents 5–8% of all congenital heart disease. Although balloon expandable stents provide an established treatment option for native or recurrent coarctation, outcomes from transverse arch (TAO) stenting, including resolution of hypertension have not been well studied. This study aims to evaluate immediate and midterm results of TAO stenting in a multi‐center retrospective cohort.
Methods
TAO stenting was defined as stent placement traversing any head and neck vessel, with the primary intention of treating narrowing in the transverse aorta. Procedural details, complications and medications were assessed immediately post procedure, at 6 month follow‐up and at most recent follow‐up.
Results
Fifty‐seven subjects, 12 (21%) native, and 45 (79%) surgically repaired aortic arches, from seven centers were included. Median age was 14 years (4 days–42 years), median weight 54 kg (1.1–141 kg). After intervention, the median directly measured arch gradient decreased from 20 mmHg (0–57 mmHg) to 0 mmHg (0–23 mmHg) (p < .001). The narrowest arch diameter increased from 9 mm (1.4–16 mm) to 14 mm (2.9–25 mm) (p < .001), with a median increase of 4.9 mm (1.1–10.1 mm). One or more arch branches were covered by the stent in 55 patients (96%). There were no serious adverse events. Two patients warranted stent repositioning following migration during deployment. There were no late complications. There were 8 reinterventions, 7 planned, and 1 unplanned (6 catheterizations, 2 surgeries). Antihypertensive management was continued in 19 (40%) at a median follow‐up of 3.2 years (0.4–7.3 years).
Conclusions
TAO stenting can be useful in selected patients for resolution of stenosis with minimal complications. This subset of patients are likely to continue on antihypertensive medications despite resolution of stenosis.
Details
- Title: Subtitle
- Acute and medium term results of balloon expandable stent placement in the transverse arch—a multicenter pediatric interventional cardiology early career society study
- Creators
- Shabana Shahanavaz - Washington University in St. LouisOsamah Aldoss - University of Iowa Stead Family Children’s HospitalKaitlin Carr - University of IowaBrent Gordon - Loma Linda University Children's HospitalMichael D. Seckeler - University of ArizonaGurumurthy Hiremath - University of MinnesotaCameron Seaman - University of AlbertaJenny Zablah - Children's Hospital ColoradoGareth Morgan - Children's Hospital Colorado
- Resource Type
- Journal article
- Publication Details
- Catheterization and cardiovascular interventions, Vol.96(6), pp.1277-1286
- Publisher
- John Wiley & Sons, Inc
- DOI
- 10.1002/ccd.29248
- PMID
- 32902911
- ISSN
- 1522-1946
- eISSN
- 1522-726X
- Number of pages
- 10
- Language
- English
- Date published
- 11/2020
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984353838802771
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