Stent implantation for native and recurrent coarctation significantly reduced systolic blood pressure from 144 mmHg to 128 mmHg (P<0.0005), with 68% of patients normotensive at 30 months.
Cohort (n=43)
Does stent implantation reduce the blood pressure gradient and systemic blood pressure in children and young adults with coarctation of the aorta?
Stent implantation for coarctation of the aorta safely and effectively reduces the blood pressure gradient, though arterial hypertension persists in approximately one-third of patients at midterm follow-up.
Absolute Event Rate: 128% vs 144%
p-value: p=< 0.0005
AIMS: The current study was designed to assess midterm results of stent implantation into the aorta for native and recurrent coarctation (CoA) in children and young adults. METHODS AND RESULTS: Forty-three patients (native CoA, 8; female, 12) were treated with stent implantation at a median age of 16.8 years (range 7.9-44.8 years). Only stents dilatable to an adult size aorta were implanted. All but two patients with functionally univentricular hearts had arterial hypertension. Exercise tests, 24-h blood pressure, clinical examination, echocardiography, and elective catheterization were used to assess follow-up. The narrowed segment was widened significantly from a median of 8 to 12.4 mm (P < 0.0005). The peak-to-peak gradient between the ascending and the descending aorta was lowered significantly from a median of 22 mmHg to 1 mmHg (P < 0.0005). No major complications occurred. The systolic blood pressure at the right arm was lowered significantly (P < 0.0005) from 144 mmHg before stent implantation to 128 mmHg at the last visit. At a median follow-up of 30 months (3-72 months), 68% of all patients were classified to be normotensive. CONCLUSION: Stent implantation for selected patients with recurrent and native CoA is safe and may effectively reduce the blood pressure gradient across the CoA site. We suggest using only stents dilatable to an adult size aorta. However, arterial hypertension persists in a significant number of the patients. Impaired elastic properties of the aorta may be the cause for this finding.
Eicken et al. (2006) conducted a cohort in Native and recurrent coarctation (CoA) (n=43). Stent implantation was evaluated on Systolic blood pressure at the right arm (mmHg) (p=< 0.0005). Stent implantation for native and recurrent coarctation significantly reduced systolic blood pressure from 144 mmHg to 128 mmHg (P<0.0005), with 68% of patients normotensive at 30 months.
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