@Article{CHD.2021.015896,
AUTHOR = {Marie Laure Yammine, Camilla Calvieri, Marcello Chinali, Salvatore Giannico, Giulia Cafiero, Ugo Giordano},
TITLE = {Surgical Versus Percutaneous Stenting Treatment of Isolated Aortic Coarctation: Long-Term Follow-Up},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {16},
YEAR = {2021},
NUMBER = {5},
PAGES = {457--467},
URL = {http://www.techscience.com/schd/v16n5/42685},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> 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. <b>Methods:</b> 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. <b>Results: </b>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 (<i>p</i> = 0.002). Pulse pressure values were higher in CoA-PS patients compared to the others (<i>p</i> < 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 (<i>p</i> < 0.0001). Indeed, stenting was associated to higher incidence of re-coartaction (<i>p</i> < 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 (<i>p</i> ≤ 0.001). <b>Conclusion:</b> 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.},
DOI = {10.32604/CHD.2021.015896}
}