Division of Cardiac Surgery, Department of Surgery, University of Alberta, Canada.
Division of Cardiology, Department of Medicine, University of Alberta, Canada.
Int J Cardiol. 2021 Jan 15;323:267-270. doi: 10.1016/j.ijcard.2020.10.048. Epub 2020 Oct 23.
This study examines the contemporary medium- and long-term outcomes of endovascular repair of aortic coarctation in the adult.
We reviewed the clinical and imaging data of 56 consecutive adult patients with aortic coarctation who underwent endovascular repair at the Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada, from 2003 to 2018.
There were 20 (35.7%) female and 36 (64.3%) male patients (including 9 re-intervention cases) with a mean age of 33.6 ± 13.6 years. Thirty-seven (66.1%) were treated with balloon-expandable covered stent and 12 (21.4%) were treated with balloon-expandable bare-metal stent. Pressure gradients decreased from baseline level of 27.99 ± 12.75 (8-70) mm Hg to 5.33 ± 4.42 (0-17.5) mm Hg following the procedure. There were 2 (3.6%) procedure related complications (aortic dissection [n = 1] and stent malposition [n = 1]). During a median (Q1 - Q3) follow up of 5.36 (2.28-7.58) years, 2 deaths (4.2%) and 9 (19%) re-interventions occurred, and the overall survival was 95.8%.
Percutaneous coarctoplasty, with either covered or bare metal stents, is a safe and durable option for aortic coarctation repair with excellent long-term survival.
本研究旨在探讨成人主动脉缩窄血管内修复的近期和中期结果。
我们回顾了 2003 年至 2018 年期间在加拿大阿尔伯塔省埃德蒙顿市马赞斯基艾伯塔心脏研究所接受血管内修复的 56 例成人主动脉缩窄连续患者的临床和影像学资料。
共有 20 例（35.7%）女性和 36 例（64.3%）男性患者（包括 9 例再次介入治疗病例），平均年龄为 33.6±13.6 岁。37 例（66.1%）采用球囊扩张覆膜支架治疗，12 例（21.4%）采用球囊扩张裸金属支架治疗。术后压力梯度从基线水平 27.99±12.75（8-70）mmHg 降至 5.33±4.42（0-17.5）mmHg。有 2 例（3.6%）与手术相关的并发症（主动脉夹层[n=1]和支架位置不当[n=1]）。在中位数（Q1-Q3）为 5.36（2.28-7.58）年的随访期间，有 2 例死亡（4.2%）和 9 例（19%）再次介入治疗，总生存率为 95.8%。
经皮缩窄成形术，无论是使用覆膜支架还是裸金属支架，都是一种安全且持久的主动脉缩窄修复选择，具有极好的长期生存率。
