Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 11-12, Pages: 728-735
https://doi.org/10.2298/SARH1112728K
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Stenting aortic coarctation in children: Immediate and midterm results
Košutić Jovan (Odeljenje kardiologije, Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Prijić Sergej (Odeljenje kardiologije, Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Vukomanović Vladislav (Odeljenje kardiologije, Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Rakić Sanja (Odeljenje kardiologije, Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Kuburović Vladimir (Odeljenje kardiologije, Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Introduction. Stent implantation, in patients with different forms of aortic
coarctation, has significant theoretical advantages over primary balloon
dilatation (BD). It can achieve overdilatation of the coarcted segment with
the rigid endoprothesis maintaining the increase in vessel diameter
regardless of the intimal injury and, thus, reducing the likelihood of
restenosis. Moreover, by preventing vascular recoil, stents can successfully
expand long-segment tubular coarctations, hypoplastic isthmus and hypoplastic
transverse aortic arch. Finally, by facilitating good apposition of the torn
intima to the aortic wall, they can significantly reduce the incidence of
aneurysm formation. Objective. Evaluation of the immediate and mid-term
results of stent implantation in patients with different forms of aortic
coarctation. Methods. Between February 2005 and March 2010 eleven stents were
implanted in nine patients (two female and seven male) either with post
surgical or post primary BD residual coarctation/recoarctation or with native
aortic coarcatation. Mean age of our patients was 14±3 years (9.4-18.1 years)
and mean body weight 54±18 kg (29-76 kg). Results. Pressure gradient across
the coarctation site was reduced from 24.9±12.4 mm Hg before to 3.9±5.0 mm Hg
after stenting (p=0.000). There were no complications. Mean followup was
2.0±1.5 years (range 0.1-5.2 years). In patients with localised aortic arch
narrowing no restenosis or aneurysm formation was observed (residual pressure
gradient 0-5 mm Hg). Conclusion. In properly selected children (body weight
>25 kg), adolescents and young adults stenting is the method of choice for
patients with various forms of aortic arch obstruction.
Keywords: stent, aortic coarctation, children