Document Detail


Open surgical repair and endovascular treatment in adult coarctation of the aorta.
MedLine Citation:
PMID:  21035699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to compare the results of endovascular therapy (covered stenting) with surgical technique to repair aortic coarctation in adults.
METHODS: A prospective study of 11 patients who were treated during the past 10 years was carried out. Of these, five patients underwent endoprosthesis (group A) and six an open surgical repair (group B). Follow-up comprised monitoring of the blood pressure, echocardiography, and computed tomography and magnetic resonance angiographic studies.
RESULTS: The mean age of the patients was 46 years (range: 17-67 years) and the mean follow-up was 52.6 months (range: 1-117 months; 32.3 for group A vs. 69.7 for group B; p = 0.01). Two cases in group A were recoarctations after child angioplasty. The rate of postoperative complications was 27.7% (one hemothorax for group A vs. one pneumothorax and one hemothorax for group B); however, mortality did not occur. The success rate of the endovascular technique was 80%. The stay in the intensive care unit was 2.3 days with significant differences (one group A vs. three group B; p = 0.01), whereas length of hospital stay was 11 days (7.8 group A vs. 11.83 group B; p = 0.17). The pressure gradient across the stenosis decreased by 21.9 ± 3.7 mm Hg (24.5 ± 4.3 group A vs. 33 ± 3.2 group B). Six patients (54.5%) showed persistent hypertension (80% group A vs. 33% group B), with a mean residual pressure gradient of 23.4 ± 4.3 mm Hg (22.5 ± 5.4 group A vs. 22 ± 2.1 group B; p = 0.58).
CONCLUSIONS: Short- and medium-term results of the endovascular therapy are similar, with shorter stay in the intensive care unit and higher necessity of antihypertensive treatment. Echocardiography and Doppler aortic coarctation gradients slightly higher than 20 mm Hg are usual during follow-up.
Authors:
Enrique M San Norberto García; José A González-Fajardo; Vicente Gutiérrez; Beatriz Fernández; Alberto San Román; Carlos Vaquero
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  24     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2011-02-15     Revised Date:  2011-12-06    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1068-74     Citation Subset:  IM    
Copyright Information:
Copyright © 2010. Published by Elsevier Inc.
Affiliation:
Division of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, Spain. esannorberto@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antihypertensive Agents / therapeutic use
Aortic Coarctation* / diagnosis,  physiopathology,  surgery
Aortography / methods
Blood Pressure
Blood Pressure Determination
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation
Chi-Square Distribution
Echocardiography, Transesophageal
Endovascular Procedures* / adverse effects,  instrumentation
Female
Humans
Intensive Care
Length of Stay
Magnetic Resonance Angiography
Male
Middle Aged
Prospective Studies
Spain
Stents
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Doppler
Vascular Surgical Procedures* / adverse effects
Young Adult
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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