Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Iran.
Am J Cardiol. 2010 Nov 1;106(9):1327-31. doi: 10.1016/j.amjcard.2010.06.063.
We report our experience with stent implantation for treatment of aortic coarctation in patients with Turner syndrome. Ten consecutive patients with Turner syndrome and aortic coarctation (median age 12 years, range 9 to 24) underwent coarctation stenting. Of these, 6 patients were treated for isolated coarctation and 4 for recurrent coarctation (3 after balloon dilation and 1 after balloon dilation and surgical repair). Bare metal stents were implanted in 7 patients and covered stents in 3. Immediately after stent implantation, peak systolic gradient decreased from 46.1 ± 24.3 to 1.9 ± 2.1 mm Hg (p <0.001). Aortic diameter at coarctation site increased from 5.1 ± 3.2 to 15.3 ± 2.0 mm after stenting (p <0.001). There were no deaths or procedure-related complications. During a median follow-up of 30.5 months, no patient developed restenosis. Two patients developed late aortic aneurysms at the coarctation site. In conclusion, stent implantation for aortic coarctation in patients with Turner syndrome appears to be a safe and effective alternative to surgical repair. Larger cohorts and longer-term follow-up are required to determine the effects of the procedure on the aortic wall.
我们报告了我们在 Turner 综合征患者中使用支架植入治疗主动脉缩窄的经验。10 例连续的 Turner 综合征合并主动脉缩窄患者(中位年龄 12 岁,范围 9 至 24 岁)接受了缩窄支架植入术。其中 6 例为单纯性缩窄,4 例为复发性缩窄(3 例为球囊扩张后,1 例为球囊扩张和手术修复后)。7 例患者植入裸金属支架,3 例患者植入覆膜支架。支架植入后即刻,收缩期峰值梯度从 46.1 ± 24.3 降至 1.9 ± 2.1 mm Hg(p <0.001)。支架植入后,缩窄部位的主动脉直径从 5.1 ± 3.2 增至 15.3 ± 2.0 mm(p <0.001)。无死亡或与手术相关的并发症。中位随访 30.5 个月期间,无患者发生再狭窄。2 例患者在缩窄部位出现迟发性主动脉瘤。总之,支架植入术治疗 Turner 综合征患者的主动脉缩窄似乎是一种安全有效的手术修复替代方法。需要更大的队列和更长时间的随访来确定该手术对主动脉壁的影响。