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[我们在成人主动脉缩窄支架植入方面的初步经验]

[Our initial experience with stent implantation for aortic coarctation in adults].

作者信息

Yazıcı Hüseyin Uğur, Göktekin Omer, Ulus Taner, Temel Kerem, Nadir Aydın, Nasifov Muharrem, Birdane Alparslan, Unalır Ahmet, Ata Necmi

机构信息

Department of Cardiology, Medicine Faculty of Eskişehir Osmangazi University, Eskişehir, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2011 Apr;39(3):214-8. doi: 10.5543/tkda.2011.01439.

Abstract

OBJECTIVES

We evaluated the procedural success and short-mid term results of stent implantation for aortic coarctation in adults.

STUDY DESIGN

The study included 15 consecutive patients (9 women, 6 men; mean age 27±7 years; range 17 to 45 years) treated with stent implantation for aortic coarctation. Fourteen patients had native, one patient had recurrent coarctation. Nine patients received bare metal and six patients received covered Cheatham-Platinum stents. Covered stents were used in patients with accompanying patent ductus arteriosus (n=2), severe coarctation (n=3), and recurrent coarctation (n=1). Procedural success was defined as the reduction in the pressure gradient across the coarctation site to less than 20 mmHg. The mean follow-up period was 10.4±4.6 months (range 3 to 18 months).

RESULTS

Stent implantation was successful in all the patients. Compared to the preprocedure figures, systolic gradient across the aortic coarctation decreased from 37.2±11.3 mmHg to 3.5±2.9 mmHg, the diameter of the coarcted aortic segment increased from 5.4±1.5 mm to 17.2±1.4 mm, and systolic blood pressure declined from 154±9.7 mmHg to 130±7.3 mmHg following stenting (for all, p<0.001). There were no procedure-related major complications.

CONCLUSION

Stent implantation for aortic coarctation in adults is a safe and effective alternative to surgical correction.

摘要

目的

我们评估了成人主动脉缩窄支架植入术的手术成功率及短期和中期结果。

研究设计

该研究纳入了15例连续接受主动脉缩窄支架植入术的患者(9例女性,6例男性;平均年龄27±7岁;范围17至45岁)。14例患者为原发性主动脉缩窄,1例为复发性主动脉缩窄。9例患者接受裸金属支架,6例患者接受覆膜Cheatham - Platinum支架。覆膜支架用于伴有动脉导管未闭的患者(n = 2)、严重主动脉缩窄患者(n = 3)和复发性主动脉缩窄患者(n = 1)。手术成功定义为缩窄部位的压力梯度降至20 mmHg以下。平均随访期为10.4±4.6个月(范围3至18个月)。

结果

所有患者的支架植入均成功。与术前数据相比,主动脉缩窄部位的收缩期梯度从37.2±11.3 mmHg降至3.5±2.9 mmHg,缩窄主动脉段的直径从5.4±1.5 mm增加至17.2±1.4 mm,支架植入后收缩压从154±9.7 mmHg降至130±7.3 mmHg(所有数据,p<0.001)。没有与手术相关的重大并发症。

结论

成人主动脉缩窄的支架植入术是手术矫正的一种安全有效的替代方法。

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