Early and mid-term outcomes of Cheatham platinum stent for the native aortic coarctation

【摘要】 Background Aortic coarctation(CoA)is a common congenital cardiovascular defect. Until now,there is no unified conclusions about the therapeutic options of the native aortic coarctation(CoA)in adolescents and adults. Methods From May 2010 to April 2018,consecutive 23 patients(median age 25 years,range 15-57 years)with native CoA underwent endovascular repair by applying covered Cheatham platinum(CP)stent in our center. Related variables were retrospectively collected and analyzed. Results Ten cases were complicated with other congenital heart diseases. Hypertension was confirmed in 21(91.3%)patients. In these patients,thirteen cases(61.9%)had a normal blood pressure without drug treatment during follow-up.The systolic right arm blood pressure significantly decreased from a mean of 150.7±6.4 mmHg pre-operation to 128.0±12.5 mmHg discharge(P<0.001),and the diastolic pressure decreased from 82.0±10.0 to 73.1±6.8 mmHg(P<0.001). The diameter of the coarcted segment increased from 5.0±2.3 to 16.9±2.3 mm(P<0.001). The peak systolic gradient significantly decreased from 64.9±20.9 to 7.1 ±6.1 mm Hg(P<0.001). The median follow-up was 30 months(range 1 months to 7.9 years). Complications were found in 4 people within one month:1 suspected cardiovascular-related death,1 new aortic dissection,1 splenic infarction,and 1 path-related arterial occlusion.Conclusions Our limited experience demonstrated that stent implantation is a reliable technique for the management of native aortic coarctation in adolescents and adults. Our intermediate-term results seem encouraging,however,the early complications should be considered. A larger series of cases with a longer follow-up is needed to substantiate these results.[S Chin J Cardiol 2020;21(1):30-37]更多还原

【Abstract】 Background Aortic coarctation(CoA)is a common congenital cardiovascular defect. Until now,there is no unified conclusions about the therapeutic options of the native aortic coarctation(CoA)in adolescents and adults. Methods From May 2010 to April 2018,consecutive 23 patients(median age 25 years,range 15-57 years)with native CoA underwent endovascular repair by applying covered Cheatham platinum(CP)stent in our center. Related variables were retrospectively collected and analyzed. Results Ten cases were complicated with other congenital heart diseases. Hypertension was confirmed in 21(91.3%)patients. In these patients,thirteen cases(61.9%)had a normal blood pressure without drug treatment during follow-up.The systolic right arm blood pressure significantly decreased from a mean of 150.7±6.4 mmHg pre-operation to 128.0±12.5 mmHg discharge(P<0.001),and the diastolic pressure decreased from 82.0±10.0 to 73.1±6.8 mmHg(P<0.001). The diameter of the coarcted segment increased from 5.0±2.3 to 16.9±2.3 mm(P<0.001). The peak systolic gradient significantly decreased from 64.9±20.9 to 7.1 ±6.1 mm Hg(P<0.001). The median follow-up was 30 months(range 1 months to 7.9 years). Complications were found in 4 people within one month:1 suspected cardiovascular-related death,1 new aortic dissection,1 splenic infarction,and 1 path-related arterial occlusion.Conclusions Our limited experience demonstrated that stent implantation is a reliable technique for the management of native aortic coarctation in adolescents and adults. Our intermediate-term results seem encouraging,however,the early complications should be considered. A larger series of cases with a longer follow-up is needed to substantiate these results.[S Chin J Cardiol 2020;21(1):30-37]更多还原