Key result
Aortic stenting eliminates a 40 mmHg pressure gradient in pediatric PDA occluder-induced aortic isthmus stenosis.
Why the study?
Aortic isthmus stenosis caused by a previously implanted patent ductus arteriosus occluder is a rare complication requiring effective management strategies.
Does aortic stenting resolve aortic isthmus stenosis caused by a patent ductus arteriosus occluder in a pediatric patient?
Case Report (n=1)
Does aortic stenting resolve aortic isthmus stenosis caused by a patent ductus arteriosus occluder in a pediatric patient?
Aortic stenting with an expandable device is an effective and minimally invasive treatment for aortic isthmus stenosis caused by a previously implanted patent ductus arteriosus occluder in a growing child.
May support stenting for rare PDA occluder stenosis; leaves open need for larger series on durability.
We present a case report of stenting the aortic isthmus to manage a rare complication – stenosis caused by the patent ductus arteriosus occlude previously implanted to a child at the age of 7 months. After 7 years the patient was re-admitted to the cardiology hospital with the signs and symptoms of the aortic coarctation. The echocardiography revealed a peak pressure gradient of 40 mm Hg in the area of the aortic isthmus. The pressure gradient between the upper and lower extremities was 25-30 mm Hg. At the age of 8 the compromised blood flow in the aorta was completely resolved by stenting the aortic isthmus with covering of the implanted occluder. Andrastent XL (Andramed GmbH, Reutlingen, Germany) stent was implanted. Characteristics of this stent allow expanding it up to 14 mm. The pressure gradient in the area of the aortic isthmus was completely eliminated after the procedure. The effectiveness of the intervention was confirmed after 7 months with echocardiography. In conclusion, the aortic stenting using devices with the potential for further expansion as the child grows is justified due to its effectiveness, minimal invasiveness, and radical nature. Received 5 March 2022. Revised 10 July 2022. Accepted 11 July 2022. Informed consent: The patient’s informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article.
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Тарасов et al. (2022) conducted a case report in Aortic isthmus stenosis caused by patent ductus arteriosus occluder (n=1). Aortic stenting (Andrastent XL) was evaluated on Pressure gradient in the area of the aortic isthmus. Aortic stenting completely eliminated the 40 mm Hg peak pressure gradient in an 8-year-old child with aortic isthmus stenosis caused by a previously implanted patent ductus arteriosus occluder.
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