|Open surgical repair and endovascular treatment in adult coarctation of the aorta.|
|PMID: 21035699 Owner: NLM Status: MEDLINE|
|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.
|Enrique M San Norberto García; José A González-Fajardo; Vicente Gutiérrez; Beatriz Fernández; Alberto San Román; Carlos Vaquero|
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|Type: Comparative Study; Journal Article|
|Title: Annals of vascular surgery Volume: 24 ISSN: 1615-5947 ISO Abbreviation: Ann Vasc Surg Publication Date: 2010 Nov|
|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|
|Languages: eng Pagination: 1068-74 Citation Subset: IM|
|Copyright © 2010. Published by Elsevier Inc.|
|Division of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, Spain. email@example.com|
|APA/MLA Format Download EndNote Download BibTex|
Antihypertensive Agents / therapeutic use
Aortic Coarctation* / diagnosis, physiopathology, surgery
Aortography / methods
Blood Pressure Determination
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects, instrumentation
Endovascular Procedures* / adverse effects, instrumentation
Length of Stay
Magnetic Resonance Angiography
Tomography, X-Ray Computed
Vascular Surgical Procedures* / adverse effects
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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