Navigation Links
Bailout stenting successful treatment for infants with constricted aortas

Cardiac interventionalists and surgeons at University Clinic in Leuven, Belgium have achieved successful stent implantation and follow-up coarctectomy in premature infants suffering from aortic coarctation. Full findings are published in the March issue of Catheterization and Cardiovascular Interventions, the official journal of The Society for Cardiovascular Angiography and Interventions.

Aortic coarctation is a common congenital condition characterized by a narrowing of the aorta, a major blood vessel leaving the heart. The narrowed aorta reduces blood flow to the lower extremities and causes heart failure in infants. The condition may be diagnosed at birth or in early childhood, at which time it can be corrected by surgery, however surgical repair is extremely risky in premature babies. Prostaglandin E1 infusion is the standard treatment to recover or maintain systemic flow in a neonate (infant) with critical coarctation prior to elective surgical repair. However, this treatment may not restore sufficient blood flow in time and can be associated with considerable side effects when given for a prolonged time.

A research team led by Marc Gewillig, M.D., Ph.D., evaluated the safety and efficacy of stenting a coarcted aortic arch in critically ill neonates in order to defer corrective surgery until the infants had stabilized and gained weight. Dr. Gewillig explained, "Significant arch obstruction in critically ill infants currently requires a surgical intervention, but how and when to proceed with the surgery is crucial to successful outcomes. Our goal of stenting the coarctation was to provide the surgeon with a bigger and better patient for surgery to correct the arch obstruction."

The study covered 15 infants less than 2 months of age between January 1, 1998 and March 30, 2009. The infants were between 30-41 weeks of gestation; 8 out of 15 were premature (<37 weeks of gestation). At cardiac catheterization, the average weight of the patients was 2.5 kg and their mean age was 12 days. One group of patients had a native coarctation where surgery was not considered the best option at that time (very low-birth-weight, critically ill neonates not responding to medical treatment, complex cardiac, and noncardiac disease); a second group consisted of patients with significant early restenosis after primary surgical coarctectomy or arch repair.

Stent removal and arch reconstruction has been performed in 12 patients. One patient is still awaiting final repair. In patients with simple stented coarctation, the stent was removed after 2.8 months. In complex cardiac malformation, stents were removed after 3.0 months. The decision when to remove the stent was made for every patient individually: criteria were hemodynamic stability after the cardiogenic shock, adequate body weight to safely perform coarctectomy, or when additional surgery was planned. Most patients with simple coarctation could easily be weaned from supportive therapy as systemic output had adequately resumed. Two deaths occurred before stent removal and were nonprocedure related.

Commenting on the surgery, Dr. Gewillig said, "The surgeon felt the procedure was not complicated by the presence of the stent and the surgery was easier to perform as all structures had grown, with some catch-up growth of the distal arch."

"This study shows that early stenting (of both native coarctation or early recoarctation post surgical coarctectomy) in critically ill infants followed by later coarctectomy can be performed safely and with good results," he concluded.


Contact: Dawn Peters

Related medicine news :

1. Americans United for Life Action Fights the Abortion Bailout by Supporting the Nelson-Hatch-Casey Amendment
2. Is Bailout of Major League Baseball Next? Book Explains How Baseball Like Big Businesses Will Fail
3. No Bailout Needed: Long Term Care Insurance Leader Declares Dividend, Plans Strong 2009 Growth
4. Billions for Bank Bailouts, But How to Rebuild the Brands? NeuroFocus Reveals New Brainwave-Based Solutions
5. FRC Condemns President Obamas $441 Million Bailout of International Abortions
6. President Obama Gives the Unborn at Least a 24 Hour Reprieve, Postpones $441 Million Bailout of International Abortions, Says Family Research Council
7. Caregivers Need a Bailout Too! (or 1% for Families)
8. After Financial Bailout, a Long Term Care Bailout? No, Industry Expert Says, Pointing to Recent Congressional Action
9. Stenting May Save Legs
10. Aspirin Alone Works Best to Prevent Clots a Year After Stenting
11. EPIC study finds new embolic protection device had 97.5 percent success rate during carotid artery stenting
Post Your Comments:
(Date:11/26/2015)... ... November 26, 2015 , ... Patients at Serenity ... have come together on Thanksgiving Day to share the things that they are ... the Serenity Point YouTube channel, patients displayed what they wrote on index cards, ...
(Date:11/26/2015)... (PRWEB) , ... November 26, 2015 , ... ... a real-time eReferral system for diagnostic imaging in the Waterloo region. Using the ... and Nuclear Medicine tests directly from their electronic medical record (EMR) without the ...
(Date:11/26/2015)... ... , ... The Catalent Applied Drug Delivery Institute today announced ... form selection in early phase drug development. The first of these is to ... the UK’s emerging life sciences companies, corporate partners, and investors, at Milton Park, ...
(Date:11/26/2015)... ... November 26, 2015 , ... PRMA Plastic Surgery is updating their record books ... their 6,000th free flap breast reconstruction surgery! , “What an accomplishment for the PRMA ... rebuild lives and it’s an honor to have served all of these women.” , ...
(Date:11/26/2015)... ... 26, 2015 , ... Pixel Film Studios brings Final Cut ... Vintage. This newly styled ProTrailer pack comes with 30 all-new vintage-inspired designs, with ... users limitless opportunities to stylize and create designs quickly and easily, all within ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , November 26, 2015 ... the "Self Administration of High Viscosity Drugs" ... ) has announced the addition of the ... report to their offering. --> Research ... addition of the "Self Administration of High ...
(Date:11/25/2015)... , Nov. 26, 2015  The total global healthcare industry ... over 2015-2016. Latin America has the ... , (excluding Japan ), is second with ... continues to face increased healthcare expenditure. In 2013-2014, total government ... from 43.5% in 2008-2009 to 41.2% in 2013-2014. In real ...
(Date:11/25/2015)... , Nov. 25, 2015 On Tuesday, ... federal bellwether trial against Wright Medical Technology, Inc. ... their Conserve metal-on-metal hip implant device, awarded $11 ... a two week trial and three days of ... hip device was defectively designed and unreasonably dangerous, ...
Breaking Medicine Technology: