eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
4/2017
vol. 13
 
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abstract:
Original paper

Native aortic coarctation stenting in patients ≥ 46 years old

Małgorzata Szkutnik
,
Sylwia Sulik
,
Roland Fiszer
,
Beata Chodór
,
Jan Głowacki
,
Jacek Białkowski

Adv Interv Cardiol 2017; 13, 4 (50): 302–306
Online publish date: 2017/11/29
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Introduction: Stent implantation is an effective therapy for aortic coarctation (CoA) in adolescents and adults.

Aim: To present a unique group of patients with native coarctation of the aorta older than or equal to 46 years treated with bare metal or covered stents.

Material and methods: Since 2002 we have performed stent implantations by applying bare metal stents or covered stents using femoral access in 24 patients aged 46 and older.

Results: We used the Mullins technique in all cases, implanting different stents: Palmaz, Cheatham-Platinum (CP), covered CP or Andrastents XL/XXL. Twenty-one procedures were elective and 3 were urgent. Eighteen bare metal stents (2 stents in one patient) and 7 covered stents were used. All procedures were effective (CoA gradient reduced < 20 mm Hg), despite 2 migrations of bare metal stents. Mean gradient was reduced from 50.6 ±15.3 to 6.8 ±6.5 mm Hg (p < 0.001) and mean lumen diameter of stenosed aorta increased from 5.5 ±2.5 to 14.9 ±5.2 mm (p < 0.001). One special case is discussed – a 49-year-old man with end staged heart failure and severe CoA, who underwent a rescue procedure with a bare metal stent. One serious complication – stroke of the central nervous system – was observed in a 53-year-old woman during covered stent implantation (symptoms resolved during rehabilitation process).

Conclusions: Stent implantation of native coarctation of the aorta is also a safe procedure in the eldest patients and is associated with persistent relief of aortic obstruction.
keywords:

aortic coarctation, bare metal stent, peripheral intervention

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