Background Aortic coarctation(CoA)is a common congenital cardiovascular defect. Until now,there is no unified conclusions about the therapeutic options of the native aortic coarctation(CoA)in adolescents and adults. M...Background Aortic coarctation(CoA)is a common congenital cardiovascular defect. Until now,there is no unified conclusions about the therapeutic options of the native aortic coarctation(CoA)in adolescents and adults. Methods From May 2010 to April 2018,consecutive 23 patients(median age 25 years,range 15-57 years)with native CoA underwent endovascular repair by applying covered Cheatham platinum(CP)stent in our center. Related variables were retrospectively collected and analyzed. Results Ten cases were complicated with other congenital heart diseases. Hypertension was confirmed in 21(91.3%)patients. In these patients,thirteen cases(61.9%)had a normal blood pressure without drug treatment during follow-up.The systolic right arm blood pressure significantly decreased from a mean of 150.7±6.4 mmHg pre-operation to 128.0±12.5 mmHg discharge(P<0.001),and the diastolic pressure decreased from 82.0±10.0 to 73.1±6.8 mmHg(P<0.001). The diameter of the coarcted segment increased from 5.0±2.3 to 16.9±2.3 mm(P<0.001). The peak systolic gradient significantly decreased from 64.9±20.9 to 7.1 ±6.1 mm Hg(P<0.001). The median follow-up was 30 months(range 1 months to 7.9 years). Complications were found in 4 people within one month:1 suspected cardiovascular-related death,1 new aortic dissection,1 splenic infarction,and 1 path-related arterial occlusion.Conclusions Our limited experience demonstrated that stent implantation is a reliable technique for the management of native aortic coarctation in adolescents and adults. Our intermediate-term results seem encouraging,however,the early complications should be considered. A larger series of cases with a longer follow-up is needed to substantiate these results.展开更多
主动脉瓣狭窄(aortic stenosis,AS)是一种较常见的心脏瓣膜病变,而合并主动脉缩窄(coarctation of the aorta,CoA)十分罕见,发病率<1%。近年来覆膜支架置入已被广泛用于治疗CoA,而经导管主动脉瓣置换术(transcatheter aortic valve r...主动脉瓣狭窄(aortic stenosis,AS)是一种较常见的心脏瓣膜病变,而合并主动脉缩窄(coarctation of the aorta,CoA)十分罕见,发病率<1%。近年来覆膜支架置入已被广泛用于治疗CoA,而经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)作为介入新技术也逐渐在临床推广应用,但是同时经导管介入治疗CoA和AS在国内经验尚少,这对手术医师和麻醉医师来说均是一个巨大挑战。报道1例"一站式"经股动脉置入支架治疗CoA、经颈动脉TAVR治疗AS的成功病例,术后主动脉内压力阶差基本消失且未出现反流。展开更多
基金High-level Hospital Construction Project,Guangdong,China(No.DFJH201807)。
文摘Background Aortic coarctation(CoA)is a common congenital cardiovascular defect. Until now,there is no unified conclusions about the therapeutic options of the native aortic coarctation(CoA)in adolescents and adults. Methods From May 2010 to April 2018,consecutive 23 patients(median age 25 years,range 15-57 years)with native CoA underwent endovascular repair by applying covered Cheatham platinum(CP)stent in our center. Related variables were retrospectively collected and analyzed. Results Ten cases were complicated with other congenital heart diseases. Hypertension was confirmed in 21(91.3%)patients. In these patients,thirteen cases(61.9%)had a normal blood pressure without drug treatment during follow-up.The systolic right arm blood pressure significantly decreased from a mean of 150.7±6.4 mmHg pre-operation to 128.0±12.5 mmHg discharge(P<0.001),and the diastolic pressure decreased from 82.0±10.0 to 73.1±6.8 mmHg(P<0.001). The diameter of the coarcted segment increased from 5.0±2.3 to 16.9±2.3 mm(P<0.001). The peak systolic gradient significantly decreased from 64.9±20.9 to 7.1 ±6.1 mm Hg(P<0.001). The median follow-up was 30 months(range 1 months to 7.9 years). Complications were found in 4 people within one month:1 suspected cardiovascular-related death,1 new aortic dissection,1 splenic infarction,and 1 path-related arterial occlusion.Conclusions Our limited experience demonstrated that stent implantation is a reliable technique for the management of native aortic coarctation in adolescents and adults. Our intermediate-term results seem encouraging,however,the early complications should be considered. A larger series of cases with a longer follow-up is needed to substantiate these results.
文摘主动脉瓣狭窄(aortic stenosis,AS)是一种较常见的心脏瓣膜病变,而合并主动脉缩窄(coarctation of the aorta,CoA)十分罕见,发病率<1%。近年来覆膜支架置入已被广泛用于治疗CoA,而经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)作为介入新技术也逐渐在临床推广应用,但是同时经导管介入治疗CoA和AS在国内经验尚少,这对手术医师和麻醉医师来说均是一个巨大挑战。报道1例"一站式"经股动脉置入支架治疗CoA、经颈动脉TAVR治疗AS的成功病例,术后主动脉内压力阶差基本消失且未出现反流。
