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Early and Long-Term Results of Stent Implantation for Aortic Coarctation in Pediatric Patients Compared to Adolescents: a Single Center Experience


Affiliations
1 Cardiovascular Department, Giannina Gaslini Institute, 16148 Genoa, Italy
2 UOSD Epidemiology, Biostatistics and Committees, Giannina Gaslini Institute, 16148 Genoa, Italy
 

Background: Stents have become the treatment of choice for native aortic coarctation in adults and adolescents, but in pediatric patients insufficient data are currently available to identify the best therapeutic option. Methods: To compare the outcomes of pediatric and adolescent patients, we retrospectively evaluated early and long-term results of stenting for aortic coarctation in 34 patients divided into 2 groups (A and B) composed, respectively, of 17 children (mean age 8.2±2.3, weight ≤30 kg) and 17 adolescents (mean age 14.3±1.7, weight >30 kg). Results: No significant differences in outcomewere found between groups immediately after the procedure. In all of our patients, peak systolic gradient pressure significantly decreased after stenting from 43.7±12 to 1.7±3.1mmHg in group A and from 39.4 ± 16.8 to 1.6 ± 3 in group B (p < 0.0001). We observed early and late adverse events in both groups: early femoral vessel injury or thrombosis was more frequent in younger patients, as well as restenosis due to vessel growth requiring stent redilatations, often complicated by stent fractures. Data from long-term follow-up showed that, in younger patients, stress-related hypertension was more frequent. Conclusions: The procedure was immediately safe and effective in both groups. Pediatric patients must be accurately selected before stenting because they could probably need reinterventions and stents could impact on their future therapeutic perspectives.
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  • Early and Long-Term Results of Stent Implantation for Aortic Coarctation in Pediatric Patients Compared to Adolescents: a Single Center Experience

Abstract Views: 61  |  PDF Views: 0

Authors

Sara Bondanza
Cardiovascular Department, Giannina Gaslini Institute, 16148 Genoa, Italy
Maria Grazia Calevo
UOSD Epidemiology, Biostatistics and Committees, Giannina Gaslini Institute, 16148 Genoa, Italy
Maurizio Marasini
Cardiovascular Department, Giannina Gaslini Institute, 16148 Genoa, Italy

Abstract


Background: Stents have become the treatment of choice for native aortic coarctation in adults and adolescents, but in pediatric patients insufficient data are currently available to identify the best therapeutic option. Methods: To compare the outcomes of pediatric and adolescent patients, we retrospectively evaluated early and long-term results of stenting for aortic coarctation in 34 patients divided into 2 groups (A and B) composed, respectively, of 17 children (mean age 8.2±2.3, weight ≤30 kg) and 17 adolescents (mean age 14.3±1.7, weight >30 kg). Results: No significant differences in outcomewere found between groups immediately after the procedure. In all of our patients, peak systolic gradient pressure significantly decreased after stenting from 43.7±12 to 1.7±3.1mmHg in group A and from 39.4 ± 16.8 to 1.6 ± 3 in group B (p < 0.0001). We observed early and late adverse events in both groups: early femoral vessel injury or thrombosis was more frequent in younger patients, as well as restenosis due to vessel growth requiring stent redilatations, often complicated by stent fractures. Data from long-term follow-up showed that, in younger patients, stress-related hypertension was more frequent. Conclusions: The procedure was immediately safe and effective in both groups. Pediatric patients must be accurately selected before stenting because they could probably need reinterventions and stents could impact on their future therapeutic perspectives.