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Original Article

. 2017; 8(3): 72-77


Stenting of Aortic Coarctation: Immediate and Intermediate Follow-up Results

Vijaykumar Janakaloti Ramachandra Reddy, Huliyurdurga Srinivasasetty Natraj Setty, Babu Reddy, Jayarangnath, Cholenahalli Nanjappa Manjunath.

Abstract
Background: Coarctation of the aorta occurs in about 6% to 8%of patients with congenital heart disease Surgery,
balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction.
Objective: Assess the initial and intermediate term results of stent implantation in all age groups with both native and
recurrent coarctation of aorta. Patients and design: A total of 23 patients (14 [65.4%] males and 9 [34.6%] females)
with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen (82.6%) of these patients
had native COA and four (17.38%) had recurrent COA.(one after previous coarctation stenting with stent fracture and
three after balloon dilatation). Clinical data was collected at baseline, before discharge, and at follow-up and included
upper and lower extremity systolic/diastolic blood pressure, as well as the need for antihypertensive medication , and
echocardiographic data like COA gradient, associated lesions and concentric LVH. During procedure pre and post cath
gradient across coarctation segment taken, along with assessment for any complications. Results: Immediately after
stent implantation the peak systolic cath gradient (mean (SD)) fell from 61.6 (13.3) to 8.1 (3.6) mm Hg (p = 0.00). The diameter
of the stenotic lesion increased from 4.58 (0.5) mm to 14.8 (1.3) mm (p < 0.05). There were no deaths or procedure
related complications. Only one patient (4.34%) developed early complications. Acute procedural success was 91%.
During the follow-up of one month 3 (13%) of the patients had re-stenosis. At a mean follow up of 14 months, 4 cases
of re-coarctation were identified echocardiographically and 43.47% had chronic systemic hypertension, requiring drug
therapy. Conclusions: Stent implantation for the treatment of coarctation of the aorta appears to have very low morbidity
and mortality, and good intermediate term results. Endovascular stenting could be an effective and safe method, even in
all age group of patients with native and recurrent COA.

Key words: Coarctation of aorta, Coarctationstenting, Recoarctation, Intermediate, Congenital heart disease.


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