Open Access iconOpen Access

ARTICLE

Surgical Versus Percutaneous Stenting Treatment of Isolated Aortic Coarctation: Long-Term Follow-Up

Marie Laure Yammine#,*, Camilla Calvieri#, Marcello Chinali, Salvatore Giannico, Giulia Cafiero, Ugo Giordano

Pediatric Cardiology and Cardiac Surgery Department, Bambino Gesù Children's Hospital, Institute for Treatment and Research, Piazza S. Onofrio 4, Rome, 00165, Italy

* Corresponding Author: Marie Laure Yammine. Email: email
# Both authors have equally contributed to this work

Congenital Heart Disease 2021, 16(5), 457-467. https://doi.org/10.32604/CHD.2021.015896

Abstract

Background: In recent decades, aortic stenting has become a promising alternative to surgery for both native aortic coarctation and re-stenosis in children and adults. However, comparative long-term outcomes have poorly been investigated. Methods: We included 212 patients with previous aortic repair (19 ± 8.7 years) divided into 3 groups: 139 with single-time surgical repair (CoA-S group); 18 with single-time percutaneous stenting (CoA-PS group); and 55 hybrid patients with multiple aortic procedures because of re-coarctation occurrence (CoA-H group). All patients underwent 24-hour ambulatory blood pressure monitoring and trans-thoracic echocardiography. Results: After a median follow-up of 17 years after aortic repair, antihypertensive therapy was recorded in a significantly higher proportion of patients (83%) in CoA-PS group compared to 65% and 46% of CoA-H and CoA-S groups, respectively (p = 0.002). Pulse pressure values were higher in CoA-PS patients compared to the others (p < 0.001). Echocardiogram showed significant residual aortic gradient in 50% of CoA-PS and 73% of CoA-H patients compared to 33% of CoA-S patients (p < 0.0001). Indeed, stenting was associated to higher incidence of re-coartaction (p < 0.0001). At multivariate regression Cox analysis adjusted for age at repair and need for antihypertensive therapy, percutaneous stenting was an independent predictor of echocardiographic evidence of re-coarctation (p ≤ 0.001). Conclusion: Aortic coarctation stenting was independently associated with re-coartaction occurrence during long-term follow up when compared to surgical procedures. Furthermore, patients with aortic stenting had lower blood pressure control at 24-hour ambulatory blood pressure monitoring and higher need for antihypertensive therapy.

Keywords


Cite This Article

APA Style
Yammine, M.L., Calvieri, C., Chinali, M., Giannico, S., Cafiero, G. et al. (2021). Surgical versus percutaneous stenting treatment of isolated aortic coarctation: long-term follow-up. Congenital Heart Disease, 16(5), 457-467. https://doi.org/10.32604/CHD.2021.015896
Vancouver Style
Yammine ML, Calvieri C, Chinali M, Giannico S, Cafiero G, Giordano U. Surgical versus percutaneous stenting treatment of isolated aortic coarctation: long-term follow-up. Congeni Heart Dis. 2021;16(5):457-467 https://doi.org/10.32604/CHD.2021.015896
IEEE Style
M.L. Yammine, C. Calvieri, M. Chinali, S. Giannico, G. Cafiero, and U. Giordano, “Surgical Versus Percutaneous Stenting Treatment of Isolated Aortic Coarctation: Long-Term Follow-Up,” Congeni. Heart Dis., vol. 16, no. 5, pp. 457-467, 2021. https://doi.org/10.32604/CHD.2021.015896



cc Copyright © 2021 The Author(s). Published by Tech Science Press.
This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 1672

    View

  • 1102

    Download

  • 0

    Like

Share Link