Sara Bondanza1, Maria Grazia Calevo2, Maurizio Marasini1
1Cardiovascular Department, Giannina Gaslini Institute, 16148 Genoa, Italy
2UOSD Epidemiology, Biostatistics and Committees, Giannina Gaslini Institute, 16148 Genoa, Italy
Tóm tắt
Background. Stents have become the treatment of choice for native aortic coarctation in adults and adolescents, but in pediatric patients insufficient data are currently available to identify the best therapeutic option.Methods. To compare the outcomes of pediatric and adolescent patients, we retrospectively evaluated early and long-term results of stenting for aortic coarctation in 34 patients divided into 2 groups (A and B) composed, respectively, of 17 children (mean age8.2±2.3, weight ≤30 kg) and 17 adolescents (mean age14.3±1.7, weight >30 kg).Results. No significant differences in outcome were found between groups immediately after the procedure. In all of our patients, peak systolic gradient pressure significantly decreased after stenting from43.7±12to1.7±3.1 mmHg in group A and from39.4±16.8to1.6±3in group B (p<0.0001). We observed early and late adverse events in both groups: early femoral vessel injury or thrombosis was more frequent in younger patients, as well as restenosis due to vessel growth requiring stent redilatations, often complicated by stent fractures. Data from long-term follow-up showed that, in younger patients, stress-related hypertension was more frequent.Conclusions. The procedure was immediately safe and effective in both groups. Pediatric patients must be accurately selected before stenting because they could probably need reinterventions and stents could impact on their future therapeutic perspectives.
