Author + information
- Received February 11, 2015
- Revision received April 13, 2015
- Accepted May 7, 2015
- Published online August 24, 2015.
- José Suárez de Lezo, MD, PhD∗∗ (, )
- Miguel Romero, MD, PhD∗,
- Manuel Pan, MD, PhD∗,
- Javier Suárez de Lezo, MD, PhD∗,
- José Segura, MD, PhD∗,
- Soledad Ojeda, MD, PhD∗,
- Djordje Pavlovic, MD, PhD∗,
- Francisco Mazuelos, MD, PhD∗,
- José López Aguilera, MD∗ and
- Simona Espejo Perez, MD†
- ∗Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain
- †Department of Radiology, Reina Sofia University Hospital, University of Córdoba and IMIBIC, Córdoba, Spain
- ↵∗Reprint requests and correspondence:
Dr. José Suárez de Lezo, Department of Cardiology, Reina Sofía University Hospital, Avenida Menéndez Pidal s/n, 14004 Córdoba, Spain.
Objectives This study sought to determine whether several anatomic or evolving characteristics of the coarctation may create challenging conditions for treatment.
Background Stent repair of coarctation of aorta is an alternative to surgical correction.
Methods We analyzed our 21-year experience in the percutaneous treatment of complex coarctation of aorta. Adverse conditions for treatment were as follow: 1) complete interruption of the aortic arch (n = 11); 2) associated aneurysm (n = 18); 3) complex stenosis (n = 30); and 4) the need for re-expansion and/or restenting (n = 21). Twenty patients (33%) belonged to more than 1 group. Ten interruptions were type A and 1 was type B. The mean length of the interrupted aorta was 9 ± 11 mm. The associated aneurysms were native in 8 patients and after previous intervention in 10 patients. Aneurysm shapes were fusiform in 8 patients and saccular in 10. The following characteristics defined complex stenosis as long diffuse stenosis, very tortuous coarctation, or stenosis involving a main branch or an unusual location. Patients previously stented at an early age, required re-expansion and/or restenting after reaching 16 ± 5 years of age.
Results Two patients had died by 1-month follow-up. The remaining 58 patients did well and were followed-up for a mean period of 10 ± 6 years. Late adverse events occurred in 3 patients (5%). All remaining patients are symptom-free, with normal baseline blood pressure. Imaging techniques revealed good patency at follow-up without associated aneurysm or restenosis. The actuarial survival free probability of all complex patients at 15 years was 92%.
Conclusions Stent repair of complex coarctation of aorta is feasible and safe. Initial results are maintained at later follow-up.
Dr. Pan has received lecture fees from Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 11, 2015.
- Revision received April 13, 2015.
- Accepted May 7, 2015.
- 2015 American College of Cardiology Foundation