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Bailout stenting successful treatment for infants with constricted aortas
Date:3/18/2010

ight 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.


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Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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